Effectiveness of a pharmacist-nurse intervention on resolving medication discrepancies for patients transitioning from hospital to home health care.
OBJECTIVE
The effectiveness of a collaborative pharmacist-nurse intervention on resolving detected medication discrepancies as patients transitioned from hospital to home health care was evaluated.


METHODS
Patients age 50 years or older who were transitioning from hospital to home health care with qualifying diagnoses were eligible for study inclusion. Patients were assigned to a control or intervention group based on the geographic location of the patients' home. For the intervention group, the study coordinator initiated consultation with the nurse case manager to facilitate discrepancy resolution. Patients in the control group received usual care after the initial home visit by the study coordinator. Rehospitalization rates and the number of planned and unplanned physician visits were analyzed. Descriptive statistics were used to characterize and contrast patients in each study group. Equivalency testing was conducted to evaluate group comparability for demographic and health status variables and the use of health care services.


RESULTS
A total of 490 medication discrepancies were identified. The discrepancy resolution rates in the intervention and control groups were 67.0% and 54.6%, respectively. Assignment to the intervention group was associated with enhanced medication discrepancy resolution (r = 0.539, p = 0.001). There was a trend toward more planned and unplanned physician visits, and a trend toward a greater number of rehospitalization days.


CONCLUSIONS
A pharmacist-nurse collaboration designed to identify and resolve medication-related discrepancies in patients transitioning from the hospital to home health care led to significant improvement in medication discrepancy resolution.
Setter
Stephen M
SM
Department of Pharmacotherapy, College of Pharmacy, Washington State University, Spokane, WA 99217, USA. ssetter@smhca.org
Corbett
Cynthia F
CF
Neumiller
Joshua J
JJ
Gates
Brian J
BJ
Sclar
David A
DA
Sonnett
Travis E
TE
D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000458:organization & administration; D003152:Community Health Nursing / Q000458:organization & administration*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003299:Cooperative Behavior; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D010359:Patient Readmission / Q000706:statistics & numerical data; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D010595:Pharmacists / Q000458:organization & administration*; D011446:Prospective Studies
D004364:Pharmaceutical Preparations