The Rural PILL Program: A Postdischarge Telepharmacy Intervention for Rural Veterans

Area of Science:

• Geriatric Pharmacy
• Health Services Research
• Telehealth

Background:

• Medication management is complex for older adults, particularly after hospital discharge.
• Veterans often face challenges with medication adherence and safety post-discharge.
• Quality improvement initiatives are crucial for optimizing geriatric pharmacotherapy.

Purpose of the Study:

• To evaluate the effectiveness of the Rural Pharmacological Intervention in Late Life (PILL) program.
• To assess the impact of pharmacist-led telepharmacy on post-discharge care for rural veterans.
• To determine if the PILL program reduces acute care utilization, rehospitalizations, or mortality.

Main Methods:

• A quality improvement initiative involving 100 veterans (≥65 years) at risk for medication management issues.
• Post-discharge telepharmacy care provided by a pharmacist, including medication reconciliation and adherence assessment.
• Matched control group used for comparison, with logistic regression analyzing outcomes.

Main Results:

• Patients were discharged with an average of 16 medications and 4.4 changes.
• Significant medication errors (clerical and clinical) were identified in discharge summaries.
• Intervention group showed a 70% reduction in acute care visits within 30 days (OR=0.30).

Conclusions:

• The pharmacist-led, phone-based PILL program effectively reduced acute care utilization in veterans post-discharge.
• Telepharmacy interventions can improve medication safety and reduce healthcare costs for older adults.
• Further research may explore long-term impacts and broader implementation of such programs.