Pharmacists’ care helps trim hospital stays

A Hawaii-based research initiative that included pharmacists as part of a patient’s transition from hospital to home resulted in a drop of more than one-third in subsequent hospitalizations for medication-related emergencies.

Results of the study were published Oct. 7 in the Journal of the American Geriatrics Society.

Karen Pellegrin, director of continuing education/strategic planning for the University of Hawaii at Hilo’s Daniel K. Inouye College of Pharmacy, served as principal investigator of Pharm2Pharm, a federally funded health care program designed to give pharmacists a more prominent role in overseeing the medication routines of high-risk patients.

The program, funded by a $14.3 million CMS Health Care Innovation Award, was implemented at six nonfederal, general, acute-care hospitals on Oahu, Maui, Kauai and Hawaii island.

In 2013 and 2014 the investigators tracked more than 2,000 high-risk patients at the hospitals, 62 percent of whom were age 65 or older. Consulting pharmacists worked with the patients on medication management issues prior to discharge.

Once the patients left the hospital, they were connected to a community consulting pharmacist. All consulting pharmacists participating in the program were required to complete an eight-hour continuing education program.

Over the course of the study, the rate of medication-related hospitalizations for the age 65-plus group was 36 percent lower than that of a similar cohort in nonstudy hospitals.

The study yielded positive financial results as well.

The estimated annual cost of “avoided admissions” was more than $6 million, compared with the cost of the pharmacists, which was less than $2 million.

The results of the study have significant implications for what has become a large problem in the United States.

The federal Centers for Disease Control and Prevention estimates that 700,000 individuals are seen in hospital emergency departments for adverse drug events each year in the United States; nearly 120,000 of these patients need to be hospitalized for further treatment.

Adults age 65 and older are twice as likely as others to come to emergency departments for adverse drug events, accounting for more than 177,000 emergency visits each year. Older adults are also nearly seven times more likely to be hospitalized after an emergency visit, mainly for issues relating to a small number of medications that require strict maintenance.

“Karen put together a program that confirms that pharmacists are underused and underappreciated in our current health care system,” said co-author of the study Les Krenk, founding officer of the Hawaii Community Pharmacist Association. “I applaud her research, management and development skills that helped to show positive outcomes when pharmacists work directly with patients and their doctors outside the dispensing functions.”