Postdischarge interventions by pharmacists and impact on hospital readmission rates

J Am Pharm Assoc (2003). May-Jun 2012;52(3):358-62. doi: 10.1331/JAPhA.2012.10172.


Objectives: To determine whether a difference exists in hospital readmission rates at 60 days postdischarge between patients who saw (intervention group) or did not see (control group) a pharmacist within 60 days of discharge and to describe the number and type of pharmacist interventions.

Design: Retrospective electronic record review.

Setting: Austin, TX, from January 2006 to January 2010.

Patients: 131 adult patients aged 18 to 65 years who were on at least three prescription medications.

Intervention: Pharmacist visit within 60 days post-hospital discharge.

Main outcome measure: Hospital readmission rates at 60 days postdischarge.

Results: The intervention and control groups did not differ regarding age or gender, but the control group had a higher percentage of whites, fewer medications, and fewer diseases. Chi-square analyses revealed that of 65 patients in the control group, 28 (43.1%) were readmitted to the hospital within 60 days of discharge compared with 12 of 66 (18.2%) intervention group patients (P = 0.0020). Pharmacists provided approximately two interventions per patient. The most frequently provided pharmacist interventions were medication counseling (88.1%) and drug dosage adjustment (52.2%).

Conclusion: Patients on multiple prescription medications and with chronic diseases may benefit from a pharmacist visit within 60 days of hospital discharge. However, future studies are needed to further determine the effectiveness of pharmacists' interventions post-hospital discharge.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Counseling
  • Drug Prescriptions
  • Electronic Health Records
  • Female
  • Humans
  • Male
  • Medication Therapy Management
  • Middle Aged
  • Patient Discharge / statistics & numerical data*
  • Patient Readmission / statistics & numerical data*
  • Pharmaceutical Preparations / administration & dosage
  • Pharmacists*
  • Retrospective Studies
  • Young Adult


  • Pharmaceutical Preparations