Authors (including presenting author) :
Ip WT(1)(2), Yuen JSH(1), Yau WY(2), Lai WY(2), Lim WL(2)
Affiliation :
(1)School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong (2)Pharmacy Department, Prince of Wales Hospital, New Territories East Cluster
Keyword 1: :
Ward Pharmacist
Keyword 2: :
Medication Reconciliation
Keyword 3: :
Discharge Counseling
Keyword 4: :
30-day Readmission Rate
Introduction :
Ward pharmacist service in Prince of Wales Hospital has been implemented since 2019 with recent service expansion to renal ward 10A and respiratory ward 10B. The effectiveness of clinical pharmacist integration in help preventing prescribing errors was clear. The significance of pharmacist-led interventions on subsequent patients’ clinical treatment outcomes was yet not being assessed. No similar local study evaluating the effect of pharmacist discharge care on readmissions in medical wards in an acute hospital was performed.
Objectives :
(1) to evaluate the impact of clinical pharmacist integration in patient care on 30-day readmission rate; (2) to identify potential risk factors associated with readmissions
Methodology :
This is a retrospective cross-sectional study conducted in renal ward 10A and respiratory ward 10B. The characteristics for patients discharged within March to June 2024 were compared to those who discharged one year before when ward pharmacist service was not available. Patients who were not admitted through A&E, were receiving less than five regular chronic medications, deceased cases, discharged against medical advice or to rehabilitation hospital were excluded. The primary outcome was subsequent unscheduled hospital admission within 30 days after the index episode of admission.
Result & Outcome :
The current analysis included 260 patients with a mean age of 73.7 ± 13.3. Hospital readmissions within 30 days were experienced in 21 patients (16.2%) within the intervention group and 35 patients (26.9%) within the control group. The odd of having readmission was halved for patients in the intervention group than the control group (OR, 0.50; 95% CI, 0.27-0.93; p = 0.028). Sub-group analyses showed that patients had a higher number of medications and a higher Medication Regimen Complexity Index (MRCI) were associated with an increased risk of 30-day readmissions. Clinical pharmacist integration in patient hospitalization care was significantly associated with a reduction on the rate of subsequent unplanned readmissions within 30 days. The effect of pharmacist detailed counselling education and careful medication reconciliation could be beneficial in preventing patients from readmitting.
