Outcomes of Pharmacist-Conducted Admission Medication-Regimen Reviews in Long-term Care Facilities

Abstract

Objective To assess the outcomes of pharmacist-completed aMRRs. The 2018 installation of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act requires medication regimen reviews (aMRR) upon admission to long-term care (LTC) hospitals, nursing facilities, and inpatient-rehabilitation facilities. While the legislation does not require that pharmacists perform the reviews, pharmacists are aptly suited to add value to this practice. Design Retrospective analysis of residents admitted to LTC facilities. Setting Twenty-four LTC facilities located in Arizona served by one pharmacist-consult service. Patients, Participants Cohort of 603 LTC residents whose medical records were reviewed by consultant pharmacists during March 2020. Results For 603 residents, 1092 aMRRs were completed and 921 interventions were made. The most prevalent interventions were medication monitoring (N = 276), medications without appropriate indication (N = 130), and overdosage (N = 116). Of 921 interventions, 41 were classified as ECA Level 6, avoided hospital admission, and 30 as Level 7, avoided life-threatening event. Of 165 recommendations rated by both pharmacy student assessors and a supervising postgraduate year 2 resident, agreement occurred in 161 (97.6% agreement, kappa reliability = 0.934). Conclusion Pharmacist-conducted aMRRs identified clinically important threats to patient safety. Study results demonstrate potential for positive economic and resident care outcomes from pharmacist-performed aMRR interventions.