A post-discharge pharmacist clinic to reduce hospital readmissions: a retrospective cohort study

出院后药剂师诊所降低医院再入院率:一项回顾性队列研究

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Abstract

BACKGROUND: Patients transitioning from secondary to primary healthcare are at increased risk of medication errors, adverse drug events and readmission to hospital. Incorporating a post-discharge follow-up by a hospital pharmacist has been proposed as a potential strategy to reduce readmissions. AIM: To determine the impact of a hospital-based pharmacist-led post-discharge medication review clinic on 30-day hospital readmissions in adult patients. METHOD: A single-site, retrospective cohort study compared the medical records of patients who attended the Pharmacist Review and EValuation of Existing and New Therapies (PREVENT) clinic between 1 January 2018 and 31 December 2019 to a group of case-matched control patients who did not attend the clinic. Patient inclusion criteria comprised those 18 years and older and attended the PREVENT clinic within 30 days of discharge. The matched group was based on gender, age and hospital metrics. The primary outcome measure is unplanned, all-cause 30-day hospital readmission. RESULTS: There were 170 patients per group, with similar baseline characteristics. There were significantly less unplanned all-cause 30-day hospital readmissions in the PREVENT clinic group (n = 12 (7.1%)) compared to the control group (n = 40 (23.5%), χ(2) = 17.799, p < 0.001). CONCLUSION: This study demonstrates that a hospital-based pharmacist-led post-discharge medication review clinic reduced 30-day hospital readmissions in adult patients compared to a group of case-matched controls. This study provides evidence to support extending pharmaceutical care beyond the inpatient hospital setting into the early post-discharge period, particularly in hospitals providing comprehensive clinical pharmacy services.

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