Study shows pharmacists can save millions in cost by reducing medication-related mishaps among the elderly
The study, headed by the UH Hilo pharmacy college, confirms pharmacists are underused and under-appreciated in the current Hawaiʻi healthcare system.
Research headed by the University of Hawaiʻi at Hilo shows medication-related emergencies decrease among those age 65 and older when pharmacists are part of a patient’s transition from hospital to home, saving millions in cost.
“(Centers for Disease Control) researchers have previously estimated that across the U.S. adverse drug events cause nearly 100,000 emergency hospitalizations annually among patients who are 65 and older,” says Karen Pellegrin, director of continuing education and strategic planning at the UH Hilo pharmacy college. Pellegrin is principal investigator for the $14.3 million federally funded health care program called Pharm2Pharm, designed to give pharmacists a more proactive role in overseeing high-risk patients’ medication routines.
“We designed and implemented a pharmacist intervention to change those numbers here in Hawaiʻi and the results are in,” Pellegrin explains. “The medication-related hospitalization rate among older adults decreased by more a third and the estimated annual cost of avoided admissions was over $6 million compared to the cost of the pharmacists, which was less than $2 million.”
The study
Researchers evaluated the association between the Pharm2Pharm intervention and the costs of medication-related hospitalization among older adults over a period of two years.
The findings are detailed in a research paper appearing this month in the Journal of the American Geriatrics Society, a peer-reviewed source for health care professionals in geriatric medicine and gerontology.
- See Reductions in Medication-Related Hospitalizations in Older Adults with Medication Management by Hospital and Community Pharmacists: A Quasi-Experimental Study.
The study examined the pharmacist intervention at six nonfederal, general, acute care hospitals with 50 or more beds in 2013 and 2014, including the four largest hospitals in Hawaiʻi’s three rural counties of Maui, Kauaʻi, Hawaiʻi, and two hospitals in Honolulu County. The other five hospitals on Oʻahu were tracked as a comparison group.
Hawaiʻi Health Information Corporation, the private nonprofit corporation that maintains the only all-payer hospital database in the state, provided the medication-related admission rate per 1,000 admissions of individuals aged 65 and older by quarter for each hospital from 2010 through 2014.
During the two-year implementation period, more than 2,000 high-risk inpatients were enrolled in Pharm2Pharm at the intervention hospitals. Of those enrolled, 62 percent were aged 65 and older. Based on a statistical model, the rate of medication-related hospitalizations in individuals aged 65 and older was 36 percent lower in the intervention hospitals by the last quarter of 2014 than in the nonintervention hospitals.
This research is important in part, Pellegrin says, because community pharmacists who dispense prescription medications typically have little access to clinical information about the patients, limiting their ability to identify and resolve drug therapy problems.
Les Krenk, founding officer of the Hawai’i Community Pharmacist Association and owner of the first community pharmacy to participate in the Pharm2Pharm model, is co-author of the study.
“Karen put together a program that confirms that pharmacists are underused and underappreciated in our current healthcare system,” says Krenk. “I applaud her research, management and development skills that helped to show positive outcomes when pharmacists work directly with patients and their doctors outside of the dispensing functions.”
Further research is needed in larger, more-urban hospitals, to determine whether similar results would be achieved.
The project described is supported by Funding Opportunity CMS-1C1–12–0001 from CMS Center for Medicare and Medicaid Innovation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Health and Human Services or any of its agencies.
