A Pharmacist-Led Intervention to Increase Inhaler Access and Reduce Hospital Readmission (PILLAR)

Le résumé fourni par la source

Background: COPD is a leading diagnosis for hospital readmissions and a focus of the Centers for Medicare & Medicaid Services Hospital Readmission Reduction Program, which penalizes hospitals for avoidable readmissions. Research Question: Does a pharmacist-led evaluation and recommendation of chronic inhaler therapy before hospital discharge impact time to hospital readmission and emergency department (ED) visit? Study Design and Methods: A single-center randomized controlled trial at a large academic medical center enrolled admitted patients prescribed a long-acting inhaler. Patients received usual care or the intervention wherein a pharmacist reviewed inhaler therapy and provided recommendations for those with inappropriate therapy based on insurance formulary preference or clinical guidelines before discharge. The primary outcome was the combined time (days) to either hospital readmission or ED visit after hospitalization measured 6 months postdischarge. Similar analyses were performed for patients with and without COPD. Results: = .009). Interpretation: In a group of patients receiving long-acting inhaler therapy for various indications, a significant reduction in risk of time to readmission/ED visit was not seen between the intervention and usual care groups. However, a significant reduction in risk of time to readmission/ED visit was observed for patients with COPD in the intervention group, suggesting an opportunity for pharmacist inhaler therapy review for financial and clinical appropriateness to reduce avoidable readmissions. Clinical Trial Registration: ClinicalTrials.gov; No.NCT03927820; URL: www.clinicaltrials.gov.

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