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Pharmacist-led initiative cuts readmission rates

Telephone follow-up by pharmacists after patients are discharged from hospital reduced 30- and 90-day readmission rates, with up to a 50-fold return on investment, researchers from Northern Ireland report.

Pharmacists scheduled telephone calls with patients within 10 days, at one month and at the start of the third month after discharge. They used a structured guide to reveal issues or problems patients experienced with their treatment or illness, including adherence, concerns regarding their medicines and their ability to manage their medication. Pharmacists offered practical individualised advice.

Researchers matched 211 people who received telephone follow-up with the same number of controls. Each group received, on average, about 12.5 medicines and was aged, on average, 68.8 years. Readmission rates among patients who received telephone follow-up were 43 and 47 per cent lower at 30 and 90 days respectively than among controls.

Readmission rates among those who received all three calls were 78 and 66 per cent lower at 30 and 90 days compared with their matched controls.

The mean length of hospital stay was 8.3 and 6.7 days for the follow-up and control groups respectively. The mean time to readmission was 70.9 days for the telephone follow-up group and 60.1 days for controls. In those who received all three calls, the mean time to readmission was 78.0 days compared with 58.9 days in their matched controls.

Telephone calls from the pharmacists reduced patients’ concerns about their medication and improved adherence based on responses to a beliefs about medicine questionnaire and a medication adherence report scale. Indeed, 83.8 per cent of patients reported that the calls improved their control of their medicines.

Each pound spent delivering the service saved £29.62 and £23.58 at 30 and 90 days respectively, largely due to the avoided readmissions. In those who received all three calls, each pound invested saved £51.19 and £38.08 at 30 and 90 days respectively.

The study had limitations, such as being from a single centre, considering all-cause readmission and being unable to verify whether the primary care team implemented the pharmacists’ recommendations.

However, the authors comment that the “study clearly illustrates the benefits of a pharmacist-led intervention tailoring support to address perceptions and practicalities regarding optimal medicines usage delivered by telephone followup after discharge from hospital”.

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