Evaluation of Pharmacist Medication Education and Post-discharge Follow-up in Reducing Readmissions in Patients With ST-Segment Elevation Myocardial Infarction (STEMI)

Abstract

Background: Hospital readmissions have been shown to contribute to both patient morbidity and rising health care expenditures across a number of disease processes. Adherence to a cardioprotective drug regimen is particularly important after ST-segment elevated myocardial infarction (STEMI) because it is an acute condition associated with high patient morbidity and mortality. Objective: The objective of this study was to evaluate the effectiveness of pharmacist intervention with regard to reduction in hospital readmissions and improvement in medication adherence and literacy. Methods: This was a prospective single-center study in which patients admitted with STEMI who received stents between January 2015 and April 2015 were included. Pharmacist intervention included medication reconciliation, medication education, facilitation of the delivery of discharge medications, and post-discharge telephone calls within 48 to 72 hours. A retrospective review of historical STEMI patients who did not have pharmacist transitions of care support was performed to compare readmission rates. Results: All-cause readmission at 30 days decreased from 13% to 5% ( P = 0.18). Twelve of 95 patients in the historical control group were readmitted, compared to 2 of 40 patients in the intervention group. In the historical group, 3 of 12 patients required subsequent stent placement upon readmission, compared to none in the intervention group., Medication adherence and literacy scores improved significantly from baseline to high adherence and literacy at 30 days post-discharge ( P = 0.0005). Conclusion: Pharmacist involvement in medication education signficantly improved medication adherence and literacy. There was a reduction in 30-day readmission rates, but the results were not statistically significant.