Clinical pharmacist home visits and 30-day readmissions in Medicare Advantage beneficiaries

Abstract

Rationale, aims & objectives A variety of transition of care interventions has been evaluated to date to reduce readmissions. No studies evaluated effectiveness of clinical pharmacist's home-visits to recently discharged Medicare Advantage patients with the goal of preventing subsequent readmissions and urgent care use. The objective of this study was to evaluate the effectiveness of in-home clinical pharmacist's transition of care program on 30-day all-cause readmissions, emergency department (ED) visits, outpatient visits, as well as to assess patient satisfaction with the program. Methods The study used retrospective cohort design. Results A total of 245 patients were included in the study (mean (SD) age 77.8 (8.7); mean Charlson's Comorbidity Index 5.0 (2.5); 53.5% male). Forty-seven patients (19.0%) experienced at least one ED visit and twenty-two patients (9.0%) were readmitted within 30 days. The two groups did not differ on available demographic and clinical characteristics (p > 0.05). There was no difference in 30-day readmission rates, percent of patients with ≥1 ED visit, ≥1 outpatient physician office visit between the groups (p > 0.05). A total of 78 program participants responded to a satisfaction survey with 95% agreeing the program helped to stay healthy at home. Conclusion Multiple medication-related problems were identified by in-home pharmacists and the program appeared to be well-accepted by participants. In this study we did not find that the program had an impact on reduction of inpatient or urgent healthcare use. Further research using a different study design and a larger sample to estimate the program effectiveness is warranted.