Susan P. Bell|Jeffrey L. Schnipper|Kathryn Goggins|Aihua Bian|Ayumi Shintani|Christianne L. Roumie|Anuj K. Dalal|Terry A. Jacobson|Kimberly J. Rask|Viola Vaccarino|Tejal K. Gandhi|Stephanie Labonville|Daniel Johnson|Erin B. Neal|Sunil Kripalani
Effect of Pharmacist Counseling Intervention on Health Care Utilization Following Hospital Discharge: A Randomized Control Trial
Vanderbilt University|Brigham and Women's Hospital|Harvard University|Vanderbilt University|Vanderbilt University Medical Center|Vanderbilt University Medical Center|VA Tennessee Valley Healthcare System|Vanderbilt University|Brigham and Women's Hospital|Harvard University|Brigham and Women's Hospital|Harvard University|Emory University|Emory University|National Patient Safety Foundation|Brigham and Women's Hospital|Harvard University|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University
reduction 30day readmission rates following hospitalization acute coronary syndrome acs acute decompensated heart failure adhf national goalthe aim study determine effect tailored pharmacistdelivered health literacy intervention unplanned health care utilization including hospital readmission emergency room er visit following dischargerandomized controlled trial concealed allocation blinded outcome assessorstwo tertiary care academic medical centersadults hospitalized diagnosis acs andor adhfpharmacistassisted medication reconciliation inpatient pharmacist counseling lowliteracy adherence aids individualized telephone followup dischargethe primary outcome time first unplanned health care event defined hospital readmission er visit within 30 days discharge prespecified analyses conducted evaluate effects intervention academic site health literacy status inadequate versus adequate cognition impaired versus impaired adjusted hazard ratios ahr 95 confidence intervals ci reporteda total 851 participants enrolled study vanderbilt university hospital vuh brigham womens hospital bwh primary analysis showed statistically significant effect time first unplanned hospital readmission er visit among patients received interventions compared controls ahr 104 95 ci 078139 interaction treatment effect site p 004 interaction vuh ahr 077 95 ci 051115 bwh ahr 144 95 ci 095212 intervention reduced early unplanned health care utilization among patients inadequate health literacy ahr 041 95 ci 017100 difference treatment effect patient cognitiona tailored pharmacistdelivered health literacysensitive intervention reduce postdischarge unplanned health care utilization overall intervention effective among patients inadequate health literacy suggesting targeted practice pharmacist intervention population may advantageous