Association between Discharge Pharmacist Counselling Techniques and Hospital Readmission Rate

Abstract

PURPOSE: We evaluated the impact of a new discharge counseling technique on patients' readmission rate and on identifying medication discrepancies during discharge. METHODS: A retrospective investigational study was conducted to compare the 30-day readmission rate among patients subjected to the new counseling method with those of the standard methods (primary objective). The secondary objective was to evaluate the frequency and types of drug-related problems detected at the time of discharge among both groups. Inclusion criteria were patients who were counseled using the new counseling technique and all patients who were counseled using the standard techniques over a period of 2 months. RESULTS: We identified 191 patients counseled using the standard technique and 233 patients counseled using the new technique. The readmission rate was lower by approximately 28% for the new counseling technique (21.5%) compared with those subjected to the standard one (29.8%; p < 0.05; OR: 1.56; 95% confidence interval [CI], 1.002-2.418). The discrepancies were more frequently detected among patients who were subjected to the new technique (20.6%) compared with those who were counseled using the standard technique (5.2%; p < 0.05). There were statistically significant differences regarding the type of diagnosis and sex between the two groups. The adjusted odds ratio for readmission within 30 days is 1.876 (95% CI, 1.162-3.028; p = 0.01) after adjusting for sex, and diagnosis, number of identified discrepancies, and number of medications. CONCLUSION: Our study showed that the new discharge counseling technique was associated with a lower readmission rate and improved detection of identified discrepancies 4 times more than the standard technique for identified high-risk adult and pediatric patients. Larger-scale prospective studies are needed to confirm this finding.