Pharmaceutical Care in the Reduction of Readmission Rates in Diabetes Melitus

The first outcome of the clinical study was to measure the readmission rate through a structured pharmaceutical care model after basal hospital discharge and measure the effect of this intervention in terms of readmission reduction in a short term period of 30 days, regardless of the hospitalization reason.

As secondary outcomes the investigators measured the readmission rates after basal hospital discharge and the effect of the intervention in terms of readmission reduction in 60, 90,180 and 365 days after basal hospital discharge. Also, the readmission costs in terms of cost-effectiveness were evaluate.

The sample consisted of 100 patients with DM associated with other comorbidities, hospitalized for any reason in the HCPA, of both sexes, older than 18 years.

Informed consent, demographic and validated questionnaires data were collected in the basal visit. After that, patients were randomized to:

Group 1: comparator; Group 2: structured pharmaceutical intervention.

Seven days after basal hospital discharge, drugs adherence was verified.

The interventional group received pharmaceutical care at basal hospitalization stay, after randomization, have their prescription reviewed until 7 days after discharge of basal hospitalization and also received structured phone calls and mobile SMS (Short Message Service) during one year follow up (30, 60, 180 and 365 days).

Electronic medical records of the included patients (intervention and comparator groups) were reviewed monthly for 12 months, aiming to identify access to emergency services or hospital readmissions at the HCPA and, consequently, the reasons for readmissions and outcomes.

Inclusion criteria

• Patients with DM and other comorbidities hospitalized for any reason at HCPA
• Patients who are literate or have a literate caregiver;
• Signature in the Term of Consent.

Exclusion criteria

• Limited ability to communicate and read in Portuguese and absence of responsible caregiver at the patient room;
• Neuropsychiatric diseases (psychosis, delirium or severe dementia);
• Terminal illness;
• Transplanted patients or users of warfarin, as these patients receive formal guidance from the HCPA pharmaceutical team;
• Auditory or visual impairment that, at the discretion of the investigator, prevents the patient from participating in the study;
• Do not have own mobile number or a close family member living in the same household.