Effect of Pharmacy-Supported Transition-of-Care Interventions on 30-Day Readmissions: A Systematic Review and Meta-analysis

Claire R. Rodrigues, Amanda R. Harrington, Nicole Murdock, John T. Holmes, Eliza Z. Borzadek, Kristin Calabro, Jennifer Martin, Marion K Slack

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Objective: To describe pharmacy-supported transition-of-care (TOC) interventions and determine their effect on 30-day all-cause readmissions. Data Sources: MEDLINE/PubMed, EMBASE, International Pharmaceutical Abstracts, ABI Inform Complete, PsychINFO, Web of Science, Academic Search Complete, CINHAL, Cochrane library, OIASTER, ProQuest Dissertations & Theses, ClinicalTrials.gov, and relevant websites were searched from January 1, 1995, to December 31, 2015. Study Selection and Data Extraction: PICOS+E criteria were utilized. Eligible studies reported pharmacy-supported TOC interventions compared with usual care in adult patients discharged to home within the United States. Studies were required to evaluate postdischarge outcomes (eg, rate of readmissions, hospital utilization). Randomized controlled trials, cohort studies, or controlled before-and-after studies were included. Two reviewers independently extracted data and evaluated study quality. Data Synthesis: A total of 56 articles were included in the systematic review (n = 61 858), of which 32 reported 30-day all-cause readmissions and were included in the meta-analysis. A taxonomy was developed to categorize targeted patients, intervention types, and pharmacy personnel as sole intervener. The meta-analysis demonstrated about a 32% reduction in the odds of readmission (odds ratio [OR] = 0.68; 95% CI = 0.61 to 0.75) observed for pharmacy-supported TOC interventions compared with usual care. Heterogeneity was identified (I2 = 55%; P < 0.001). A stratified meta-analysis showed that interventions with patient-centered follow-up reduced 30-day readmissions relative to studies without follow-up (OR = 0.70; CI = 0.63 to 0.78). Conclusions: Pharmacy-supported TOC programs were associated with a significant reduction in the odds of 30-day readmissions.

Original languageEnglish (US)
Pages (from-to)866-889
Number of pages24
JournalAnnals of Pharmacotherapy
Volume51
Issue number10
DOIs
StatePublished - Oct 1 2017

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Patient Transfer
Meta-Analysis
Odds Ratio
Patient Readmission
Information Storage and Retrieval
PubMed
MEDLINE
Libraries
Cohort Studies
Randomized Controlled Trials
Pharmaceutical Preparations

Keywords

  • clinical pharmacy
  • documentation interventions/outcomes
  • evidence-based practice
  • meta-analysis
  • pharmaceutical care

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Effect of Pharmacy-Supported Transition-of-Care Interventions on 30-Day Readmissions : A Systematic Review and Meta-analysis. / Rodrigues, Claire R.; Harrington, Amanda R.; Murdock, Nicole; Holmes, John T.; Borzadek, Eliza Z.; Calabro, Kristin; Martin, Jennifer; Slack, Marion K.

In: Annals of Pharmacotherapy, Vol. 51, No. 10, 01.10.2017, p. 866-889.

Research output: Contribution to journalReview article

Rodrigues, Claire R. ; Harrington, Amanda R. ; Murdock, Nicole ; Holmes, John T. ; Borzadek, Eliza Z. ; Calabro, Kristin ; Martin, Jennifer ; Slack, Marion K. / Effect of Pharmacy-Supported Transition-of-Care Interventions on 30-Day Readmissions : A Systematic Review and Meta-analysis. In: Annals of Pharmacotherapy. 2017 ; Vol. 51, No. 10. pp. 866-889.
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abstract = "Objective: To describe pharmacy-supported transition-of-care (TOC) interventions and determine their effect on 30-day all-cause readmissions. Data Sources: MEDLINE/PubMed, EMBASE, International Pharmaceutical Abstracts, ABI Inform Complete, PsychINFO, Web of Science, Academic Search Complete, CINHAL, Cochrane library, OIASTER, ProQuest Dissertations & Theses, ClinicalTrials.gov, and relevant websites were searched from January 1, 1995, to December 31, 2015. Study Selection and Data Extraction: PICOS+E criteria were utilized. Eligible studies reported pharmacy-supported TOC interventions compared with usual care in adult patients discharged to home within the United States. Studies were required to evaluate postdischarge outcomes (eg, rate of readmissions, hospital utilization). Randomized controlled trials, cohort studies, or controlled before-and-after studies were included. Two reviewers independently extracted data and evaluated study quality. Data Synthesis: A total of 56 articles were included in the systematic review (n = 61 858), of which 32 reported 30-day all-cause readmissions and were included in the meta-analysis. A taxonomy was developed to categorize targeted patients, intervention types, and pharmacy personnel as sole intervener. The meta-analysis demonstrated about a 32{\%} reduction in the odds of readmission (odds ratio [OR] = 0.68; 95{\%} CI = 0.61 to 0.75) observed for pharmacy-supported TOC interventions compared with usual care. Heterogeneity was identified (I2 = 55{\%}; P < 0.001). A stratified meta-analysis showed that interventions with patient-centered follow-up reduced 30-day readmissions relative to studies without follow-up (OR = 0.70; CI = 0.63 to 0.78). Conclusions: Pharmacy-supported TOC programs were associated with a significant reduction in the odds of 30-day readmissions.",
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AU - Murdock, Nicole

AU - Holmes, John T.

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AU - Martin, Jennifer

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