Date of Award

Summer 8-8-2017

Degree Type

Capstone Project

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Ashli Owen-Smith

Second Advisor

Jidong Huang

Abstract

Introduction: Unnecessary hospital admissions and readmissions can expose individuals to potential risks such as unnecessary treatment and can be costly to both hospitals and to patients. Approximately one in every five hospital discharges of Medicare patients is readmitted to the hospital within 30 days of discharge and the annual cost of unplanned hospital readmissions is about $17.4 billion. Under the ACA provision, the Centers for Medicare & Medicaid Services (CMS) reduces payments to hospitals that have excess 30-day readmission rates. Therefore, hospitals are particularly focused on reducing hospital readmission rates. Pharmacist-delivered interventions may be one strategy that hospitals can implement which may reduce readmission rates.

Purpose: Although medication reconciliation is recognized as one of the most effective strategies for reducing hospital readmission, the evidence regarding the effectiveness of pharmacist-delivered medication reconciliation interventions, specifically, on hospital readmission rates is mixed. The aim of this literature review is to investigate available evidence regarding the clinical and financial impact of pharmacist-delivered medication reconciliation interventions across a variety of interventions and to suggest next steps for future research, practice and policies based on this evidence.

Methods: To find available data for pharmacist-delivered medication reconciliation on hospital readmission, four electronic databases were used for selecting articles: ProQuest Central, Pubmed, Medline, CINAHL, Wiley Online library were used. During the database search, the following main keywords used were ‘medication reconciliation,' ‘transition of care,’ ‘pharmacy,' ‘adverse drug event,’ and ‘patient readmission.' Searches were limited to articles published in English.

Results: Several studies suggest that the impact of pharmacist-led medication reviews on hospital readmission rates is not clear. Some evidence does suggest, however, that pharmacist-led medication reconciliation programs does have a significant impact on improving drug-related readmissions, particularly among low health literacy patients, and may facilitate cost containment. More research is needed to address confounding factors and the role of pharmacy teams such as pharmacy interns or pharmacy technicians.

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