Collaboration on polypharmacy reduces readmission and costs of care
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Collaboration on polypharmacy reduces readmission and costs of care A post-discharge pharmacist/clinician collaborative (PCC) visit in adults discharged on polypharmacy reduces adverse events requiring hospital readmission and costs of care, according to findings of a retrospective US study published in the American Journal of Health-System Pharmacy. Data from a US hospital in adults who were discharged on polypharmacy (≥10 drugs including drugs with a high readmission risk such as anticoagulants, low molecular weight heparin, antiplatelets, insulin, other antihyperglycaemics and loop diuretics) between July 2013 and March 2016 and were eligible for PCC visits were used to evaluate the impact of a PCC visit on costs of care. The PCC visit included 30 min with a pharmacist during which the pharmacist completed medication reconciliation (including screening for drug interactions) and communicated medication recommendations to the primary care clinician prior to 30 min with the clinician. In total, 496 patients attended a PCC visit and 500 patients attended a post-discharge visit with no pharmacist involvement (usual care). At 30 days post-discharge, total costs were significantly lower in 10th and 90th cost quintiles in patients who attended a PCC visit compared with usual care (–$56 and –$4856, respectively). Costs were significantly reduced at 60 days in the 75th quintile (–$3515) and 90th quintile (–$6958), and at 180 days in the 25th, 50th and 75th quintiles (–$856, –$1984 and –$5155, respectively). "Medically complex patients had a significantly lower total cost of care in approximately half of the cost quintiles at 30, 60, and 180 days after hospital discharge if they had a collaborative pharmacist and primary care clinician visit compared to a primary care clinician–only visit," concluded the authors. "In addition to reductions in readmission risk that may occur with collaborative visits, the cost benefit shown may help support more widespread use of the intervention," they commented. Herges JR, et al. Impact of collaborative clinician visits on postdischarge total cost of care in a polypharmacy population. American Journal of Health-System Pharmacy 77: 803515031 1859-1865, No. 22, 30 Oct 2020. Available from: URL: http://doi.org/10.1093/ajhp/zxaa192
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Reactions 14 Nov 2020 No. 1830
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