Pharmacist Clinical Interventions and Discharge Counseling in Medical Rehabilitation Wards in a Local Hospital: A Prospective Trial

Pharmacist Clinical Interventions and Discharge Counseling in Medical Rehabilitation Wards in a Local Hospital: A Prospective Trial

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Patients undergoing rehabilitation experience numerous changes in medication regimens during care transitions, exposing these patients to an increased risk of drug-related problems (DRPs).A prospective, non-randomized, quasi-experimental study was conducted in medical rehabilitation wards to evaluate the impact of pharmacist-delivered interventions and counseling on 30-day unplanned health care utilization and medication adherence for selected rehabilitation patients.A pharmacist provided medication reconciliation and counseling before discharge.Phone follow-up was completed 30 days after discharge to assess for unplanned health care utilization rate blackmores ache relief focus review and medication adherence.A total of 85 patients (n = 43 in prospective intervention group and n = 42 in historical usual care group) were included.

Among the intervention group, 23 DRPs were identified in 14 (32.6%) patients, resulting in 51 interventions.The intervention group had a significantly lower unplanned health care utilization rate than the usual care group (25.6% vs.47.

6%, p = 0.035).The risk of unplanned health care utilization was reduced by over 60% (Odds ratio (OR) = 0.378; 95% CI = 0.15–0.

94).Patients reporting medium to high medication adherence increased from 23.6% to 88.4% bolia outlet gent 30 days after counseling (p < 0.05).

Pharmacist medication reconciliation and discharge counseling reduced unplanned health care utilization 30 days after discharge and improved medication adherence.