RESUMO
OBJECTIVE: This study aimed to evaluate the impact of a pharmacist-led postsurgical discharge medication reconciliation program in an accountable care organization-like setting. SETTING: Multidisciplinary primary care network in Central Ohio. PRACTICE DESCRIPTION: Ambulatory care pharmacists are integrated in a primary care network, which includes a centralized focus on assistance with population health metrics, along with an interdisciplinary team. PRACTICE INNOVATION: In May 2018, a pharmacist-led medication reconciliation postdischarge (MRP) program was initiated focused on a postsurgical discharge population. EVALUATION: A retrospective chart review was conducted to compare the 2 primary end points of overall MRP rates from 4 payers in 2017 and 2018, and the postsurgical MRP rates from May 25 to November 30 of 2017 and 2018. Secondary outcomes included description of pharmacist interventions in pharmacy-led service and 30-day readmission or emergency department (ED) utilization rates for postsurgical population. RESULTS: A total of 5837 hospitalizations were identified as eligible for overall MRP completion in 2017 (n = 2621) and 2018 (n = 3216). A 20% relative increase in overall MRP completion was reported in 2018 (P < 0.001). In 2017, 55.9% of postsurgical MRPs were completed. The implementation of the pharmacy-led MRP program led to a 41% relative increase in postsurgical MRP completion (78.9% in 2018, P < 0.001). Pharmacists completed 220 postsurgical MRPs in the 6-month study period, including 765 total recommendations for intervention and an average of 3 recommendations and 4 medication list updates per MRP. There was no statistically significant reduction in 30-day readmission and ED utilization rates in 2018 (6.8% in 2017 vs. 6.2% in 2018, P = 0.74). CONCLUSION: A pharmacy-led postsurgical discharge program led to an increase in MRP completion rates in the target postsurgical MRP population, which also positively affected the overall MRP completion rate. Pharmacists can be key players in the improvement and quality of MRP measures.