Pharmacist Home Visits Improve Heart Failure Management

Community pharmacists who expand their roles and make home visits to heart failure (HF) patients after hospital discharge can improve outcomes. That is the message extracted from a study conducted by pharmacy residents and academic staff at the University of Rhode Island.

In this study, the investigators created a community pharmacist-provided home health service featuring medication reconciliation and teaching. They provided care to patients registered with Visiting Nurse Services of Newport and Bristol Counties, Rhode Island, from December 2013 to April 2014.

The program’s goal was to improve medication adherence and reduce 30-day HF-related hospital readmissions.

A Postgraduate Year 1 community pharmacy resident visited HF patients in their homes within 1 week of their admission to visiting nurse services. During the visit, the resident conducted a baseline assessment of medication adherence and educated the patients about chronic management of HF.

The resident also made 2 follow-up phone calls to patients at 1 and 4 weeks after the visit to reassess adherence and monitor for hospital readmission.

Although this study was small, as it enrolled only 10 patients, the magnitude of improvement was notable.

At 4 weeks, 5 patients were in the high adherence category and 2 were in medium adherence. One patient was unable to complete the final follow-up, while another had died and yet another had been readmitted.

Hospital readmission rates for study participants (10%) were lower compared with agency wide figures (38%) over a similar time period.

Home health care teams rarely include pharmacists when they provide care to patients undergoing transitions in care. However, the community pharmacists in this program facilitated successful transitions of care, improved medication adherence, and decreased 30-day HF-related hospital readmission rates.

This study, which appeared in the July 2015 issue of the Journal of the American Pharmacists Association, suggests that pharmacists can play much greater roles in home health care.