Assessing the impact of pharmacist-initiated versus provider-initiated patient enrollment in Meds to Beds services.

Abstract

Purpose: This study evaluated the impact of pharmacist-initiated versus provider-initiated patient enrollment in the Meds to Beds program. The primary objective was to compare the number of high-risk readmission patients enrolled through pharmacist-initiated versus provider-initiated processes. Secondary objectives included comparing 30-day all-cause and heart failure readmission rates, number of prescriptions delivered, patients receiving pharmacist counseling, and impact on HCAHPS scores. Methods: This retrospective, single-center cohort study compared patients in the provider-initiated program (August-October 2023) with those in the pharmacist-initiated program (November 2023-February 2024) at Mount Sinai Brooklyn. Inclusion criteria for the intervention group included patients with COPD, asthma, CHF, ACS, diabetes, hypertension, or age >75. Exclusion criteria included discharges to long-term care facilities and prescriptions for C-II controlled substances. Data analysis included the number of patients being enrolled, counseling numbers, prescribed medications, and readmission rates. Data were sourced from Epic. Descriptive statistics, p-values, and chi-squared testing were used for analysis. Results: A total of 380 patients were enrolled in the pharmacist-initiated group and 162 in the provider-initiated group; 228 and 162 patients received counseling in the respective groups. Of those counseled, 19.7% in the pharmacist-initiated group were readmitted within 30 days, compared to 19.1% in the provider-initiated group. For heart failure patients, 29.6% in the pharmacist-initiated group were readmitted within 30 days, versus 36.4% in the provider-initiated group. HCAHPS scores increased by 15% from Q1 to Q4 2023. The pharmacist-initiated process saw a 26% increase in total medications prescribed. Conclusion: Pharmacists played a pivotal role in enhancing the Meds to Beds process to improve patient outcomes and satisfaction.