
Background
Approximately 1 million admissions for congestive heart failure (CHF) were responsible for $39 billion of health care cost in 20101,3.
Congestive heart failure has historically been associated with a high rate of readmission within 30 days of discharge.
New Medicare reimbursement strategies include payment reductions based upon readmission rates and patient satisfaction scores.
Medication review and discharge counseling by pharmacists were associated with a significantly lower rate of preventable adverse drug events (1% vs 11%, P = 0.01) as well as medication-related emergency department visits and hospital readmissions 30 days after hospital discharge (1% vs 8%, P = 0.03) when comparing the intervention group to the usual-care group.2
The Hospital to Home (H2H) survey conducted in 2010 indicated that 77% of hospitals reported all medication details were given to patients at discharge; however, there was a lack of standard processes for both medication reconciliation and patient education.4
Objective
Primary Endpoint
To determine if pharmacist-provided discharge medication counseling improves disease state and medication knowledge for patients with a primary diagnosis of congestive heart failure (CHF)
Secondary Endpoint
To identify the percentage of patients who are readmitted within a 30-day post-discharge period and/or the number of emergency department visits
Methods
Inclusion Criteria
Patients with a primary diagnosis of CHF located in the intermediate cardiac care unit
Exclusion Criteria
(a) Patients associated with:
(b) a cognitive deficit and no caretaker available
(c) a language barrier
(d) an expected discharge to a long term care nursing facility
Data
Data collected will include readmission rates and emergency department visits within a 30-day post-discharge period and patient demographics such as age, sex, ejection fraction (%), NYHA class, and co-morbid conditions.
Data will be analyzed with descriptive statistics and a student’s t-test.
Confidentiality Statement
Patient confidentiality will be maintained throughout this entire study
This quality initiative project will be submitted to the Institutional Review Board of Ohio Northern University for approval under exemption status
References
1. Hall MJ, Levant S, and DeFrances CJ. Hospitalization for congestive heart failure: United States, 2000-2010. U.S. Department of Health and Human Services: National Center for Health Care Statistics Data Brief. October 2012:108.
2. Schnipper JL, Kirwin JL, Cotugno MC, et al. Role of pharmacist counseling in preventing adverse drug events after hospitalization. Arch Intern Med. 2006;166:565-71.
3. Butler J and Kalogeropoulos A. Hospital strategies to reduce heart failure readmissions: Where is the evidence? J Am Coll Cardiol. 2012;60(7):615-7.
4. Bradley EH, Curry LC, Horwitz LI, et al. Contemporary evidence about hospital strategies for reducing 30-day readmissions: A national study. J Am Coll Cardiol. 2012;60(7):607-14.
Complete data will be published when availbale. For further information please contact Sylvia Stoffella.
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