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Karen L. Pellegrin

When pharmacists are part of a patient’s transition from hospital to home, research in Hawaiʻi shows medication-related emergencies decrease among those age 65 and older, saving millions more than the cost of the pharmacists annually.

CDC researchers have previously estimated that across the U.S. adverse drug events cause nearly 100,000 emergency hospitalizations annually among patients who are 65 and older,” said Karen L. Pellegrin, director of continuing education/strategic planning for the University of Hawaiʻi at Hilo Daniel K. Inouye College of Pharmacy. “We designed and implemented a pharmacist intervention to change those numbers here in Hawaiʻi and the results are in. The medication-related hospitalization rate among older adults decreased by more than a third and the estimated annual cost of avoided admissions was over $6 million compared to the cost of the pharmacists, which was less than $2 million.”

Pellegrin is the principal investigator for the Pharm2Pharm program, a $14.3 million federally funded healthcare innovation designed to give pharmacists a more integrated and proactive role in overseeing high-risk patients’ medication routines. Researchers evaluated the association between the Pharm2Pharm intervention and the costs of medication-related hospitalization among older adults over a period of two years.

The findings are detailed in a research paper appearing in the Journal of the American Geriatrics Society, a peer-reviewed source for healthcare professionals in geriatric medicine and gerontology.

Medication-related hospitalizations lower at intervention hospitals

The study examined the pharmacist intervention at six nonfederal, general, acute care hospitals with 50 or more beds in 2013 and 2014, including the four largest hospitals in Hawaiʻi’s three rural counties (Maui, Kauaʻi, Hawaiʻi) and two hospitals in Honolulu County.

During the two-year implementation period, more than 2,000 high-risk inpatients were enrolled in Pharm2Pharm at the intervention hospitals. Of those enrolled, 62 percent were aged 65 and older. Based on a statistical model, the rate of medication-related hospitalizations in individuals aged 65 and older was 36 percent lower in the intervention hospitals by the last quarter of 2014 than in the nonintervention hospitals.

This research is important in part, Pellegrin said, because community pharmacists who dispense prescription medications typically have little access to clinical information about the patients, limiting their ability to identify and resolve drug therapy problems.

“Karen put together a program that confirms that pharmacists are underused and underappreciated in our current healthcare system. I applaud her research, management and development skills that helped to show positive outcomes when pharmacists work directly with patients and their doctors outside of the dispensing functions,” said Les Krenk, co-author of the publication, founding officer of the Hawai’i Community Pharmacist Association and owner of the first community pharmacy to participate in the Pharm2Pharm model.

For more on the study, read the UH Hilo news release.

—By Alyson Kakugawa-Leong

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