Cost-effectiveness of pharmacist postdischarge follow-up to prevent medication-related admissions

Researchers conducted a study at Cedars-Sinai Medical Center in Los Angeles to measure the real-world budget effect of implementing a pharmacist follow-up program.

Researchers conducted a study at Cedars-Sinai Medical Center in Los Angeles to measure the real-world budget effect of implementing a pharmacist follow-up program. Upon admission, high-risk patients were identified as having low scores on an organizational medication literacy and adherence algorithm in addition to meeting one or more of the following criteria: receiving 10 or more chronic medications, having a diagnosis of pneumonia or congestive heart failure, or receiving anticoagulants. High-risk patients were selected for postdischarge follow-up by a transition of care (TOC) pharmacist, who compared the prior-to-admission medication list of each eligible patient with the after-visit summary discharge medication list. The TOC pharmacist contacted the discharging physician prior to and/or after patient contact to discuss and resolve any drug-related problems (DRPs) identified and to make sure the doctor's aim was carried out during the telephone follow-up call. In all, 90% of the 185 patients identified were contacted within 72 hours of discharge. Of these individuals, about 86% had at least one DRP. The 30-day intention-to-treat readmission rate for the program was 16.2% compared with 21.6% for usual care, while the respective average costs per patient were 3,433 and $4,015. In a projected 1-year analysis that assumed the pharmacy team could successfully contact and manage 150 high-risk individuals each month, the hospital's net annual savings were about $1.05 million. "This analysis revealed that a pharmacist postdischarge program is likely cost-saving to hospitals in a population health model," the authors concluded. "Hospitals may use these thresholds and lookup tables to project cost savings and help determine whether to fund and implement similar programs."