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Medication reconciliation does not impact hospital readmissions

A medication reconciliation bundle including combined pharmacist and prescriber efforts did not reduce 30-day postdischarge ED visits or readmissions to the hospital, according to research published in the Journal of Hospital Medicine.

“Health care systems are targeting effective strategies to improve patient safety and reduce hospital readmissions... Medication reconciliation was identified as one of 12 interventions that may reduce 30-day readmissions; however, rigorously designed studies are scarce,” Michelle Baker, BScPhm, from University Health Network, Toronto, and colleagues wrote.

Baker and colleagues conducted a retrospective, cohort study to determine how an interprofessional medication reconciliation process from admission to discharge affects ED visits and hospital readmissions within 30 days of discharge. The researchers used administrative databases to identify patients who were discharged from general internal medicine practices over a 57-month period (n = 8,678).

Patients in the intervention group included those who received an enhanced medication reconciliation bundle. Admission medication reconciliation and interprofessional pharmacist-prescriber collaboration on discharge were included in the enhanced bundle. The control group consisted of those who received only partial medication reconciliation.

A total of 9,931 unique patient visits were included in the analysis.

The researchers found no difference in 30-day ED visits and hospital readmissions between the intervention group and the control group (21.25% vs. 19.26%; adjusted OR = 1.06; 95% CI, 0.95-1.19). When adjusting for propensity score, no effect remained between the two groups (16.7% vs. 18.9%; relative risk of readmission = 0.88; 95% CI, 0.59-1.32).

“Researchers of future prospective studies could focus on evaluating high-risk populations or specific elements of medication reconciliation services on avoidable medication-related hospital admissions and postdischarge adverse drug events,” Baker and colleagues concluded. – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.