Pharmacy Interventions in Transitions of Care from Hospital Discharge (PITCH) Pilot Program for Medicare Part D Patients at High-Risk for Readmission

Background: Pharmacist implemented transitions-of-care (TOC) programs focus on identifying adherence issues, developing care plans, investigating medication-related insurance problems, and instilling the value of medication treatment in patients frequently admitted to hospitals for manageable, chronic disease-states. Study objective: The primary objective of this study is to determine the impact of pharmacist interventions during a TOC pilot on hospital readmission rates for patients with acute myocardial infarction (AMI), heart failure (HF), chronic obstructive pulmonary disease (COPD), or pneumonia. Methods: This study is a retrospective review of patients receiving high intensity care to prevent readmission, including pharmacy intervention during a three-month pilot period versus patients with the same disease states not receiving high intensity care. The patient population includes patients greater than 18 years of age who were admitted for AMI, HF, COPD, or pneumonia. Patients were excluded if less than 18 years of age and prisoners. Results: Hospital records identified 513 patients eligible for study inclusion following removal of exclusion patients. The study showed no statistical evidence to conclude that pharmacy intervention has effect on readmission rate when pharmacy intervention in the Medicare population was compared to the non-pharmacy intervention Medicare population (Fisher’s Exact P = 0.123). Conclusion: The study failed to show a significant difference in readmissions for patients receiving additional pharmacy care. Other factors play a role in readmission risk. Additional studies including more patients and comparing risk factors for readmission are needed to determine best practices to reduce risk while promoting patient health