Simplifying Discharge Medication Management for Complex Patients

Award Date: 2018

Project Lead(s): Kilby Rinco, Manager Operations

Project Title: Simplifying Medication Management for Complex Patients – Discharge to Home

What is the issue?

Many older adults take multiple medications for multiple chronic conditions. Those who are hospitalized may have an increased risk for adverse events after discharge if their medication plans have changed. Adverse events can lead to emergency room visits or rehospitalizations 

What did we do?

We conducted a proofofconcept study to evaluate a new software product that connects with software already used by some community pharmacies. We tested the Patient Discharge e-Portal, developed by Pharmacy Access Solutions. It sends electronic patient discharge reports directly from the hospital to community pharmacists. Our goal was to better support patients’ needs by providing community pharmacists with information on changes to medication plans before patients were discharged from the hospital. We evaluated the feasibility of providing electronic patient discharge reports directly to 14 community pharmacies and compared results with pharmacies that operated as usual using paper reports provided by patients. Seven pharmacies received software installation and training. We asked participating pharmacists to provide their feedback.  

What did we find?

The software identified several changes to medication plans. The changes included added, switched, and discontinued drugsas well as changes in dosages and frequenciesPharmacists appreciated having access to discharge medication reports. The information gave them a more complete picture of patients’ needs, an opportunity to resolve issues in advance, and helped them better manage workflow and staffing. There were not enough patients in the study to determine if this innovation reduced emergency room visits or rehospitalizations.