More and more evidence is accumulating that tele-pharmacy services improves the quality and cost effectiveness of care, especially in complex patients.  In a recent edition of Telemedicine and e-Health Hefti et. al. study the effect of a medication management program delivered via tele-health on the effect of hospital admissions (click here for full text). 

Medications are a primary driver of avoidable hospital admissions.  In addition, to the patient distress that avoidable admissions create, they also consume avoidable health care resources.  In addition, the process of post discharge medication reconciliation is a quality measure for both Medicare Advantage and DSNP plans.  Pharmacist driven medication reconciliation and management has been demonstrated to improve patients health care outcomes including minimizing avoidable readmissions.

As tele-pharmacy allows for a visual view of the patient and their environment and allows the patient to view the pharmacist clinician some have hypothesized that the tele-pharmacy interaction is more personalized and would lead to improved patient outcomes.  The authors designed a study to test this hypothesis.  That is, would access to a tele-pharmacy service decrease avoidable hospital admissions.  The authors using a retrospective, cohort design tested the difference in hospital admission rates between two groups of patients. The groups were similarly aged and the first group (n-2242) obtained care from a provider who had opted-in to using tele-pharmacy services.  The second group (n=1,540) obtained care from a provider that had opted-out of tele-pharmacy services.  The study period ran through 2019  and 2020.  Provider who had incorporated tele-pharmacy services recommended the service to their patients using six(6) or more medications. 

The authors conducted analysis to understand the difference in hospitalization rates between the two groups.  The authors noted an increase in hospitalization rates in both groups of patients during the study period.  However, the group that had access to tele-pharmacy services exhibited a reduced rise in hospitalizations (increase of 12.9%).  The group whose providers opted-out of tele-pharmacy services had an increase in hospitalizations that was significantly greater (increase of 40.2%, p<0.05, Student’s t-test).   The group with access to tele-pharmacy services had 544 hospitalizations during the evaluation period while the group without access to tele-pharmacy services had 675 hospitalizations a difference of 131 hospitalizations between the two groups.  Using an estimate of $12,000 per hospital admission, the authors concluded that tele-pharmacy medication management avoided $1.57 million over the course of the study period.

Best – Jim
Jim Notaro, RPh, PhD
Founder and Chief Clinical Officer