Reductions in Medication‐Related Hospitalizations in Older Adults with Medication Management by Hospital and Community Pharmacists: A Quasi‐Experimental Study

<jats:sec><jats:title>Objectives</jats:title><jats:p>To evaluate the association between a system of medication management services provided by specially trained hospital and community pharmacists (Pharm2Pharm) and rates and costs of medication‐related hospitalization in older adults.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Quasi‐experimental interrupted time series design comparing intervention and nonintervention hospitals using a mixed‐effects analysis that modeled the intervention as a time‐dependent variable.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Sequential implementation of Pharm2Pharm at six general nonfederal acute care hospitals in Hawaii with more than 50 beds in 2013 and 2014. All five other such hospitals served as a contemporaneous comparison group.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>Adult inpatients who met criteria for being at risk for medication problems (N = 2,083), 62% of whom were aged 65 or older.</jats:p></jats:sec><jats:sec><jats:title>Intervention</jats:title><jats:p>A state‐wide system of medication management services provided by specially trained hospital and community pharmacists serving high‐risk individuals from hospitalization through transition to home and for up to 1 year after discharge.</jats:p></jats:sec><jats:sec><jats:title>Measurements</jats:title><jats:p>Medication‐related hospitalization rate per 1,000 admissions of individuals aged 65 and older, adjusted for case mix; estimate of costs of hospitalizations and actual costs of pharmacist services.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The predicted, case mix–adjusted medication‐related hospitalization rate of individuals aged 65 and older was 36.5% lower in the Pharm2Pharm hospitals after implementation than in the nonintervention hospitals (<jats:italic>P</jats:italic> = .01). The estimated annualized cost of avoided admissions was $6.6 million. The annual cost of the pharmacist services for all Pharm2Pharm participants was $1.8 million.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The Pharm2Pharm model was associated with an estimated 36% reduction in the medication‐related hospitalization rate for older adults and a 2.6:1 return on investment, highlighting the value of pharmacists as drug therapy experts in geriatric care.</jats:p></jats:sec>