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Bingham JM, Baugham L, Hilaneh A, Tranchina K, Arku D, Eckert B, Scovis N, Turgeon J. Assessing the Impact of an Advanced Clinical Decision Support System on Medication Safety and Hospital Readmissions in an Innovative Transitional Care Model: A Pilot Study. J Clin Med 2022; 11:jcm11082070. [PMID: 35456163 PMCID: PMC9025610 DOI: 10.3390/jcm11082070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/22/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Adverse drug events and inappropriate use of medications lead to hospitalizations, medication-related morbidity, and mortality. This study examined whether a novel medication risk prediction tool, the MedWise Risk Score™, was associated with medication safety-related problem (MRP) identification and whether integration into an existing innovative transitions of care (TOC) service could decrease readmissions. (2) Methods: This retrospective comparator group study assessed patients discharged from a hospital in southern Arizona between January and December 2020. Participants were included in the study if they were 18 years of age or older, referred to the pharmacist for TOC services, and received a pharmacist consultation within one-week post discharge. Patients were categorized into two groups: (1) medication safety review (MSR)-TOC service (intervention) or (2) existing innovative TOC service (control). (3) Results: Of 164 participants, most were male (57%) and were between 70−79 years of age. Overall, there were significantly more drug-drug interactions (DDI) MRPs identified per patient in the intervention vs. control group for those who were readmitted (3.7 ± 1.5 vs. 0.9 ± 0.6, p < 0.001) and those who were not readmitted (2 ± 1.3 vs. 1.3 ± 1.2, p = 0.0120). Furthermore, of those who were readmitted, the average number of identified MRPs per patient was greater in the intervention group compared to the control (6.3 vs. 2.5, respectively, p > 0.05). Relative to the control, the readmission frequency was 30% lower in the treatment group; however, there was insufficient power to detect significant differences between groups. (4) Conclusions: The integration of a medication risk prediction tool into this existing TOC service identified more DDI MRPs compared to the previous innovative TOC service, which lends evidence that supports its ability to prevent readmissions. Future work is warranted to demonstrate the longitudinal impact of this intervention in a larger sample size.
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Affiliation(s)
- Jennifer M. Bingham
- Tabula Rasa HealthCare, Office of Translational Research & Residency Programs, 228 Strawbridge Dr, Moorestown, NJ 08057, USA; (J.M.B.); (N.S.)
- College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (L.B.); (A.H.); (K.T.); (D.A.); (B.E.)
| | - Lindsey Baugham
- College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (L.B.); (A.H.); (K.T.); (D.A.); (B.E.)
| | - Andriana Hilaneh
- College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (L.B.); (A.H.); (K.T.); (D.A.); (B.E.)
| | - Karley Tranchina
- College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (L.B.); (A.H.); (K.T.); (D.A.); (B.E.)
| | - Daniel Arku
- College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (L.B.); (A.H.); (K.T.); (D.A.); (B.E.)
| | - Becka Eckert
- College of Pharmacy, University of Arizona, Tucson, AZ 85721, USA; (L.B.); (A.H.); (K.T.); (D.A.); (B.E.)
| | - Nicole Scovis
- Tabula Rasa HealthCare, Office of Translational Research & Residency Programs, 228 Strawbridge Dr, Moorestown, NJ 08057, USA; (J.M.B.); (N.S.)
| | - Jacques Turgeon
- Tabula Rasa HealthCare, Precision Pharmacotherapy Research & Development Institute, 13485 Veterans Way, Orlando, FL 32827, USA
- Faculty of Pharmacy, Universite de Montreal, Pavillon Jean-Coutu, 2940, Chemin de la Polytechnique, Montreal, QC H3T IJ4, Canada
- Correspondence:
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