125 - Meds to Beds: A Retrospective Review Exploring the Effect of a Bedside Medication Delivery System in the Acute Inpatient Rehabilitation Setting

Thursday, February 22, 2024

5:00 PM – 6:30 PM EDT

Co-Author(s)

VT

Victoria Tran, MD

Assistant Professor
Loma Linda University
Loma Linda, California, United States
LM

Lori Lyn Mendoza, PharmD

Discharge Pharmacist
Loma Linda University
Redlands, California, United States
LP

Lisa Pham, PharmD

Clinical Pharmacist
Loma Linda University Health
San Bernardino, California, United States
NW

Noelle M. Witwer, MD

Resident Physician
Loma Linda University Health
Loma Linda, California, United States

Presenting Author(s)

AS

Aaron Shou, MD

Resident
Loma Linda University
Loma Linda, California, United States

Co-Author(s)

MM

Michael Momohara, MD

Faculty Attending Physician
Loma Linda University Health
Loma Linda, California, United States
DT

Duc A. Tran, MD PhD

Associate Program Director
Loma Linda University
Loma Linda, California, United States

Objectives: With the rising cost of healthcare in the United States, there has been an increased focus on utilization management throughout hospital systems. One area that has gained attention is post-hospital discharge readmission rates and Emergency Department (ED) or urgent care visits. Several interventions have been tried to decrease these rates, including the creation of Bedside Medication Delivery programs (BMD). However, the data regarding the benefits of such programs are mixed, and to date no study has been performed in an acute inpatient rehabilitation (AIR) setting. The purpose of this study was to see whether or not being enrolled in a BMD decreased the rate of post-discharge healthcare utilization at 30 days and 90 days of discharge from an AIR unit.

Design:
This is a retrospective cohort study. Of the 767 participants who met the inclusion criteria during the study period, 621 were enrolled in the intervention group (BMD) while 146 patients were enrolled in the control group (non-BMD). Those enrolled in the BMD received a 30-day supply of their discharge medications delivered directly to their bedside on the day of discharge and instructions by a pharmacist. Rates of post-discharge ED visits, urgent care visits, or hospital readmissions were then reviewed within 30 and 90 days of discharge.

Results: At 30 days, there was an absolute risk reduction (ARR) of 8.5% and a relative risk reduction (RRR) of 36.4% (95% CI 0.448-0.902) in unexpected post-hospital discharge utilization when subjects received BMD . At 90 days, there was an ARR of 13.0% and a RRR of 46.1% (95% CI 0.392-0.742).

Conclusions: This study demonstrates the promising potential that Bedside Medication Delivery programs have on reducing the rate of post-discharge readmissions and ED or urgent care visits after discharge from an AIR, thereby decreasing healthcare utilization.