title: Clinical pharmacist home visits and 30-day readmissions in Medicare Advantage beneficiaries.
abstract: A variety of transition of care interventions has been evaluated to date to reduce readmissions. No studies evaluated effectiveness of clinical pharmacist's home-visits to recently discharged Medicare Advantage patients with the goal of preventing subsequent readmissions and urgent care use. The objective of this study was to evaluate the effectiveness of in-home clinical pharmacist's transition of care program on 30-day all-cause readmissions, emergency department (ED) visits, outpatient visits, as well as to assess patient satisfaction with the program.
  
  
  METHODS
  The study used retrospective cohort design.
  
  
  RESULTS
  A total of 245 patients were included in the study (mean (SD) age 77.8 (8.7); mean Charlson's Comorbidity Index 5.0 (2.5); 53.5% male). Forty-seven patients (19.0%) experienced at least one ED visit and twenty-two patients (9.0%) were readmitted within 30 days. The two groups did not differ on available demographic and clinical characteristics (p > 0.05). There was no difference in 30-day readmission rates, percent of patients with ≥1 ED visit, ≥1 outpatient physician office visit between the groups (p > 0.05). A total of 78 program participants responded to a satisfaction survey with 95% agreeing the program helped to stay healthy at home.
  
  
  CONCLUSIONS
  Multiple medication-related problems were identified by in-home pharmacists and the program appeared to be well-accepted by participants. In this study we did not find that the program had an impact on reduction of inpatient or urgent healthcare use. Further research using a different study design and a larger sample to estimate the program effectiveness is warranted.
authors.affiliation: Western New England University College of Pharmacy, Springfield, MA, USA.
authors.forename: Natalia
authors.initials: N
authors.lastname: Shcherbakova
authors.affiliation: Health New England, Inc, Springfield, MA, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Tereso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D020398:Medicare Part C; D059065:Medication Reconciliation; D010359:Patient Readmission / Q000706:statistics & numerical data; D010595:Pharmacists; D024382:Professional Role; D012189:Retrospective Studies; D014481:United States
keywords: Medicare Advantage; care transitions; in-home clinical pharmacist; medication reconciliation; readmission