Do Combined Pharmacist and Prescriber Efforts on Medication Reconciliation Reduce Postdischarge Patient Emergency Department Visits and Hospital Readmissions?

@article{Baker2018DoCP,
  title={Do Combined Pharmacist and Prescriber Efforts on Medication Reconciliation Reduce Postdischarge Patient Emergency Department Visits and Hospital Readmissions?},
  author={Michelle Baker and Chaim M. Bell and Wei Xiong and Edward E. Etchells and Peter G. Rossos and Kaveh G. Shojania and Kelly Lane and Tim Tripp and Mary Lam and Kimindra Tiwana and Derek Leong and Gary G Wong and Jin-Hyeun Huh and Emily Lap Sum Musing and Olavo A Fernandes},
  journal={Journal of Hospital Medicine},
  year={2018},
  volume={13},
  pages={152–157}
}
BACKGROUND Although medication reconciliation (Med Rec) has demonstrated a reduction in potential adverse drug events, its effect on hospital readmissions remains inconclusive. OBJECTIVE To evaluate the impact of an interprofessional Med Rec bundle from admission to discharge on patient emergency department visits and hospital readmissions (hospital visits). METHODS The design was a retrospective, cohort study. Patients discharged from general internal medicine over a 57-month interval were… 

Tables from this paper

Effect of medicines management versus standard care on readmissions in multimorbid patients: a randomised controlled trial
TLDR
Investigating the effect of pharmacist-led medicines management in multimorbid, hospitalised patients on long-term hospital readmissions and survival found no statistically significant effect on time until readmission or death.
Challenges at Care Transitions: Failure to Follow Medication Changes made at Hospital Discharge.
Health interventions for the reduction of hospital readmission within 30 days in clinical patients: An integrative review
TLDR
It was found that the interventions are aimed at preparing the patient during hospitalization for the return home and post-discharge monitoring to reinforce the care plans and clarify doubts, this important combination of different actions by the multiprofessional team impacts readmission rates.
Real-Time Risk Tool for Pharmacy Interventions
TLDR
A risk tool embedded into the EMR can be used to identify patients whom pharmacy teams can easily target for AMHs, which supports allocating resources to those that will benefit the most.
Medication reconciliation: ineffective or hard to implement?
TLDR
The main result was that potentially harmful discrepancies did not decrease over time beyond baseline temporal trends and one potential explanation for the main result of Multi-Center Medication Reconciliation Quality Improvement Study (MARQUIS) is that multifaceted medication reconciliation interventions are ineffective.
Characterization of clinical pharmacist and hospitalist collaborative relationships
TLDR
Clinical pharmacists interact with hospitalists, usually on multidisciplinary teams, and it is unclear how to utilize these joint working relationships most effectively.
Dediagnosing - a novel framework for making people less ill.
Medication Reconciliation at a Glance
The article's abstract is not available.  
The right time and place: the need for seven‐day pharmacist service models
TLDR
Hospital pharmacists support the safe and quality use of medications and are ideally positioned to optimise medication safety throughout a patient’s hospital journey, but services are commonly limited to business hours.

References

SHOWING 1-10 OF 30 REFERENCES
A Reengineered Hospital Discharge Program to Decrease Rehospitalization
TLDR
This trial demonstrated that a nurse discharge advocate and clinical pharmacist working together to coordinate hospital discharge, educate patients, and reconcile medications led to fewer follow-up emergency visits and rehospitalizations than usual care alone.
Medication Safety: Effect of Medication Reconciliation with and Without Patient Counseling on the Number of Pharmaceutical Interventions Among Patients Discharged from the Hospital
TLDR
Significantly more interventions were identified after patient counseling in medication reconciliation, and most interventions led to the start of medication due to omission and dose changes due to incorrect dosages being prescribed.
Role of pharmacist counseling in preventing adverse drug events after hospitalization.
TLDR
Pharmacist medication review, patient counseling, and telephone follow-up were associated with a lower rate of preventable ADEs 30 days after hospital discharge, and medication discrepancies before and after discharge were common targets of intervention.
A pharmacy discharge plan for hospitalized elderly patients--a randomized controlled trial.
TLDR
No evidence is found to suggest that the co-ordinated hospital and community pharmacy care discharge plans in elderly patients in this study influence outcomes.
Medication Reconciliation at Hospital Discharge: Evaluating Discrepancies
TLDR
Understanding the type and frequency of discrepancies can help clinicians better understand ways to prevent them and Structured medication reconciliation may help to prevent discharge medication discrepancies.
Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: a systematic review and meta-analysis
TLDR
Pharmacist-led medication reconciliation programmes that include some component aimed at improving medication safety are effective at improving post-hospital healthcare utilisation, according to a systematic review and meta-analysis.
Hospital-based medication reconciliation practices: a systematic review.
TLDR
R rigorously designed studies comparing different inpatient medication reconciliation practices and their effects on clinical outcomes are scarce and higher-quality studies are needed to determine the most effective approaches.
Medication Reconciliation During Transitions of Care as a Patient Safety Strategy
TLDR
Evidence about the effectiveness of hospital-based medication reconciliation interventions is summarized to show that medication reconciliation alone probably does not reduce postdischarge hospital utilization but may do so when bundled with interventions aimed at improving care transitions.
Medication reconciliation: moving forward.
TLDR
A multi-disciplinary approach to inpatient medication reconciliation at an academic medical center: implementation of a comprehensive program from admission to discharge in an academic setting is recommended.
Medication reconciliation at an academic medical center: implementation of a comprehensive program from admission to discharge.
TLDR
A pharmacy-driven multidisciplinary admission history and medication reconciliation process has reduced medication errors in an academic medical center.
...
...