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Potential Adverse Drug Events and Associated Costs During Transition from Hospital to Home

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OBJECTIVE: The purpose of this study was to evaluate differences in medication discrepancy identification between pharmacists and nurses for patients 50 years of age and older receiving home health services following discharge from an inpatient hospital. It also evaluates the potential cost savings to the health care system as a result of avoiding adverse drug events (ADEs). Medication discrepancies were documented within seven days following hospital discharge.
DESIGN: The study was a secondary analysis of existing data from a completed randomized clinical trial.
SETTING: Home health care following transition from inpatient hospital care.
PARTICIPANTS: Hospitalized patients (N = 101) 50 years of age or older referred for home care services following discharge.
INTERVENTION: Existing data on medication discrepancy identification by pharmacists and nurses and potential costs of ADEs that could result were evaluated. Anticipated costs of ADEs unrecognized by nurses were estimated using Centers for Medicare & Medicaid Services claims data.
MAIN OUTCOME MEASURES: Number and severity of medication discrepancies identified by pharmacists and nurses, potential consequences for patient health and health care utilization, and anticipated costs to the health care system.
RESULTS: Pharmacists identified 677 medication discrepancies, of which 271 (40%) were considered likely to result in an ADE. Nurses identified 202 (30%) of the 677 medication discrepancies identified by pharmacists. It was estimated that approximately $9,670 in additional health care expenses could have been prevented within the cohort by pharmacist intervention.
CONCLUSION: Pharmacists identified more medication discrepancies during transition from hospital to home when compared with nurses, with the potential benefit of preventing more ADEs and saving associated health care costs during such care transitions.
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Keywords: ADVERSE DRUG EVENT; CARE TRANSITIONS; HEALTH CARE COSTS; MEDICATION DISCREPANCY; PHARMACIST

Document Type: Research Article

Publication date: June 1, 2019

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