Using pharmacy technicians to maximize pharmacist intervention with home health service patients

Abstract

ObjectivesThe objectives of this study were to assess 30- and 60-day hospitalizations and to determine the number of medication therapy problems (MTPs) identified during pharmacy technician–driven medication reconciliation for high- to very high–risk home health patients. SettingThe study was conducted in 8 independent community pharmacy locations. Practice descriptionRealo Discount Drugs is a group of 16 independent community pharmacies serving eastern North Carolina. Practice innovationRealo Discount Drugs partnered with Well Care Home Health to provide medication reconciliation services to high- and very high–risk patients. A pharmacy technician contacts the patient to obtain an accurate medication list and complete a falls risk assessment and depression screening. The technician updates the medication list, allergies, and vaccination status in the electronic health record (EHR). The pharmacist reviews the medication list for completeness; assesses for falls risk, depression, and medication interactions; and generates communication to the provider for clarifications or recommendations, if needed. Additional counseling points that need to be conveyed to the patient by the home health nurse are documented in the EHR. EvaluationThirty- and 60-day hospitalizations for enrolled patients were manually pulled from documented transfers in the EHR and compared with data from a third-party administrator. MTPs were categorized by the pharmacist and documented. Descriptive statistics were used to evaluate the data collected. ResultsAt 30 days from the start of care, 13.4% (93/695) of patients who received pharmacy services were hospitalized compared with 26.8% (143/534) of patients who did not receive pharmacy services (P < 0.01). At 60 days from the start of care, 20.9% (145/695) of patients who received pharmacy services were hospitalized compared with 33.3% (178/534) of patients who did not receive pharmacy services (P < 0.01). ConclusionA technician-driven medication reconciliation process led to a reduction in hospitalizations and identified MTPs in home health patients.