Health care centers were able to cut the hospital readmission rate for patients on dialysis by almost half in the month following discharge through use of multidisciplinary medication therapy management, according to results of poster presented at the National Kidney Foundation Spring Clinical Meetings.
The findings suggest multidisciplinary medication therapy management (MTM) programs could improve patient outcomes and reduce costs, according to the study authors.
“This is the first study to demonstrate that addressing medication-related problems post-hospital discharge through a structured and multidisciplinary MTM process can reduce 30-day readmission rates,” Harold J. Manley, PharmD, FASN, FCCP, BCPS, lead study author, said in a press release from the NKF.
The reduction in readmissions was accomplished through MTM program interventions occurring once a patient was discharged to home after a hospitalization event, according to the release. There was a three-step process: nurse medication reconciliation; a pharmacist medication review to identify any medication-related problems (MRP); and creation of a medication action plan that contained specific recommendations for physician consideration.
To reduce potential impact MRPs have on hospital readmissions, Dialysis Clinic Inc. (DCI) implemented a multidisciplinary MTM intervention, provided after a patient was discharged home across three DCI End Stage Renal Disease Seamless Care Organizations, which involved 27 dialysis clinics across four states.
According to the release, researchers of the study examined 1,276 discharges for patients released between October 2015 and April 2017. Investigators excluded patients readmitted fewer than 3 days after release, or those who died or entered hospice within 1 month.
Nearly 25% of the patient discharges received MTM intervention, resulting in a 30-day hospital readmission rate of 14% compared to 28% readmission for those discharge events that did not receive MTM interventions. Among the discharges with additional MTM intervention, investigators found a significantly lower chance of being readmitted in all three analytical methods used: univariate analyses; time-varying analyses adjusted for factors such as age, race, gender, diabetes, albumin, catheter, dialysis cause, vintage, marital status and frequent hospital admissions in prior months; and Cox regression of one-to-one match based on propensity score and program period activity.
closure: Manley reports no relevant financial disclosures.