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Developing indicators for medication-related readmissions based on a Delphi consensus study.

Nicole Schönenberger1, Anne-Laure Blanc2, Balthasar L Hug3

  • 1Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland.

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PubMed
Summary
This summary is machine-generated.

This study identified key indicators for medication-related readmissions, including poor communication, polypharmacy, and complex regimens. These findings can help healthcare providers reduce patient readmissions and improve care.

Keywords:
Clinical pharmacyDrug-related readmissionHospital dischargeMedication safetyRisk factorTransition of care

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Area of Science:

  • Pharmacoeconomics and Health Services Research
  • Patient Safety and Quality Improvement

Background:

  • Medication-related readmissions pose a significant challenge to healthcare systems, impacting patient well-being and resource allocation.
  • A lack of consensus on indicators for medication-related readmissions has hindered proactive management.

Purpose of the Study:

  • To develop a consensus-based set of indicators for identifying patients at high risk of medication-related readmission.
  • To establish a standardized tool for healthcare providers to assess readmission risk.

Main Methods:

  • A two-round Delphi study involving an expert panel of clinical pharmacists, physicians, and nursing experts.
  • Indicators were rated for relevance, and consensus was determined using the RAND/UCLA method.
  • Indicators lacking consensus were re-evaluated, and new indicators were generated and assessed.

Main Results:

  • Consensus was reached on a final set of 29 indicators for medication-related readmissions.
  • Key prioritized indicators include insufficient inter-provider communication, polypharmacy (≥7 medications), low medication adherence, complex medication regimens, and multimorbidity (≥3 chronic conditions).

Conclusions:

  • The developed indicator set can guide clinical pharmacy services at hospital discharge to prioritize patient care.
  • Implementing these indicators has the potential to improve patient outcomes and optimize resource utilization.
  • A validation study is planned to further assess the efficacy of these indicators.