Impact of Clinical Pharmacist Interventions on 30-Day Readmission Rate in Hospitalized Patients With Acute Myocardial Infarction.

Abstract

Background: Limited literature exists on the positive impact of pharmacists specifically on hospital readmission of patients with acute myocardial infarction (AMI). Objective: To evaluate the overall effect of clinical pharmacist interventions on preventing hospital readmissions and improving the health of patients with AMI. Secondary objectives include identifying trends in the demographic characteristics of AMI patients, identifying potential barriers to adherence, and assessing the average time spent by a pharmacist counseling AMI patients. Methods: This prospective, nonrandomized, single-center study was approved by the institutional review board. The hospital's 30-day AMI readmission rate prior to study initiation was used as the control group. An AMI report was generated daily to identify patients admitted to the hospital diagnosed with either non-ST or ST segment elevation myocardial infarction. The clinical pharmacist then counseled the included patient prior to discharge and provided a follow-up phone call 48 hours after discharge. The primary outcome was the all-cause 30-day readmission rate for AMI patients. Results: Out of 71 patients screened, 50 patients were included in the study. Only 3 of the 50 patients included were readmitted (6.0%). The prestudy rate from October 2012 to October 2013 was 11.6%, or 58 readmissions out of 498 AMI admissions. Although the study group was much smaller in size, a 6% readmission rate is encouraging and offers potential for a future intervention. Conclusion: Clinical pharmacist services for AMI patients, including counseling, interventions, and a follow-up phone call after discharge, may benefit decreasing the 30-day AMI readmission rate; however, further studies are needed.