Impact of a pharmacist-driven transition of care program for patients with acute coronary syndromes

Background: Pharmacist-driven transition of care (TOC) initiatives have been shown to reduce rates of medication errors and readmission rates in several patient populations, including heart failure. Existing literature evaluating pharmacist-driven TOC initiatives targeting patients with acute coronary syndromes (ACSs) are limited. Objective: To assess the impact of a newly implemented pharmacist-driven TOC initiative on readmission rates in patients with ACS. Methods: This was a retrospective, single-center, pre-post observational cohort study. Institutional review board approval was obtained. Patients were matched for age, gender, and ACS type with a historical cohort who received no pharmacist TOC intervention. The primary outcome was the 90-day all-cause readmission rate. Secondary outcomes included 30- and 90-day cardiovascular-related readmission rates as well as the 30-day all-cause readmission rate. Individual components of a pharmacist-driven TOC initiative were also evaluated to determine what, if any, aspect of the program had the greatest association with reduced readmission. Results: A total of 300 patients were included in the study; 150 patients in the pharmacist TOC group and 150 patients in the historical control group. There was a statistically significant reduction in all readmissions at 90 days in the pharmacist TOC group compared with the historical control group (24.7% vs 13.3%, P =.0124). Cardiovascular-related readmissions were also significantly reduced in the pharmacist TOC group at 30 days (11.3% vs 4.7%, P =.0333) and at 90 days (16.7% vs 8.0%, P =.0225). A higher percentage of patients who were not readmitted received pharmacist medication history and reconciliation compared with patients who were readmitted (129 [99.2%] vs 18 [90%], respectively, P =.046). Conclusions: The implementation of a pharmacist-driven TOC initiative targeting ACS patients was associated with reduced readmission rates.