Impact of a Comprehensive COPD Therapeutic Interchange Program on 30-Day Readmission Rates in Hospitalized Patients
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. The economic effect of COPD management is substantial, and the prevalence of the disease continues to rise with the growth of older populations. The purpose of this study was to evaluate the clinic...
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| Published in: | P&T (Lawrenceville, N.J.) Vol. 44; no. 4; pp. 185 - 191 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
MediMedia USA, Inc
01-04-2019
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. The economic effect of COPD management is substantial, and the prevalence of the disease continues to rise with the growth of older populations. The purpose of this study was to evaluate the clinical and financial impact of a comprehensive therapeutic interchange program (CTIP) in hospitalized patients with COPD. The primary outcome was a 30-day readmission rate, with the following secondary outcomes: 30-day mortality and pharmacy-inhaled medication cost per patient.
This study was a multi-center, retrospective, electronic chart review of patients with a diagnosis of COPD admitted to two hospitals from July 1, 2016 to June 30, 2017. Our intervention group was admitted to a 550-bed tertiary care hospital and was managed with a pharmacist-led CTIP for inhaled products used in COPD. Our control group was admitted to a 545-bed tertiary care hospital, which did not have a CTIP in place.
2,885 hospitalized patients with a diagnosis of COPD were included in the analysis (1,350 in the intervention group and 1,535 in the control group). Univariable analysis demonstrated that the intervention group was associated with a lower 30-day readmission rate (5.8% vs. 8.3%;
= 0.012) and a lower average pharmacy-inhaled medication cost ($221 vs. $311;
= < 0.01). There was no statistical difference in 30-day mortality.
This study demonstrates that the use of a pharmacist-led CTIP of COPD inhalers does not worsen patient outcomes and may provide pharmacy cost savings. The cohort managed with a CTIP was statistically associated with a lower 30-day readmission rate and lower pharmacy-inhaled medication costs without any difference in 30-day mortality. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Dr. McGurran is a PGY2 pharmacy resident at Parkland Health & Hospital System in Dallas, Texas. Dr. N. Leedahl is the Lead Pharmacist for Sanford Health Enterprise Pharmacy in Fargo, North Dakota. Dr. D. Leedahl is a Clinical Pharmacy Manager for Sanford Medical Center in Fargo, North Dakota and a Clinical Investigator with Sanford Research in Sioux Falls, South Dakota. Dr. Richter is the Director of Experiential Outreach and Assessment and Assistant Professor of Practice at North Dakota State University in Fargo. |
| ISSN: | 1052-1372 |