Using medication containers during pharmacist transitional care visits and impact on medication discrepancies identified and hospital readmission risk.

OBJECTIVE To evaluate the impact of having patients present to a pharmacist-clinician collaborative (PCC) visit after hospital discharge with their medication containers on risk of 30-day readmission. METHODS This is a retrospective cohort study from July 1, 2013 to June 18, 2018 at 5 primary care clinic sites. We included adult patients on at least 10 total medications at hospital discharge who did and did not present to the PCC visit with medication containers. Patients in both groups met with a pharmacist for 30 minutes, immediately followed by a clinician visit. Thirty-day risk of readmission was assessed using Cox proportional hazards regression. RESULTS A total of 724 qualifying patients presented for a PCC visit with their medication containers within 30 days of hospital discharge, whereas 636 did not. After adjusting for significant differences in baseline characteristics, there was no statistically significant difference in hospital readmission risk between the groups at 30 days after the visit (hazard ratio 0.94 [95% CI 0.68-1.29], P = 0.69). When patients brought their medication containers, pharmacists identified more medication discrepancies (mean ± SD, 2.2 ± 2.1 vs. 1.5 ± 1.7, P < 0.001) and made more medication therapy recommendations (1.8 ± 1.3 vs. 1.5 ± 1.2, P < 0.001) to the clinician. CONCLUSION The presence of medication containers did not affect the risk of hospital readmission, although, it did allow pharmacists to identify more medication discrepancies and medication problems. These findings support instructing patients to bring their medication containers to transitional care visits to resolve medication-related issues.