2026 Southeastern Residency Conference

EVALUATION OF MEDICATION ACCESS INTERVENTIONS BY TRANSITIONS OF CARE PHARMACIST FOR PATIENTS REQUIRING HIGH-COST CARDIAC MEDICATIONS  
Esther Cho, Alexandra Cooper, Laura Provost, Nathan Wayne, Maegan Whitworth Wellstar MCG Health – Augusta, GA 
Background/Purpose: Centers for Medicare and Medicaid Services (CMS) monitors 30-day readmission rates per the CMS Hospital Readmission Reduction Program based on relative conditions or procedures including acute myocardial infarction (AMI), heart failure (HF), and coronary artery bypass graft (CABG). These three conditions have a high readmission rate per the CDC 2021 national data, with HF having the highest readmission rate at 22% (AMI 16% and CABG 13%). Current studies show TOC interventions, by a multidisciplinary team, lower 30-day readmission, but there is no literature focusing on an exclusive pharmacist-led intervention, with a specific focus to medication access such as medication affordability. n these studies, since most hospitals do not have a dedicated Transitions of Care (TOC) pharmacists, “standard of care” is considered to be general patient care, whereas TOC interventions are established to ensure continuity and coordinate care to patients. Therefore, further evaluation is required to evaluate the effectiveness and impact of pharmacist-led TOC intervention.

Methodology: This is a retrospective chart review of adult patients who were discharged from a cardiac floor with high-cost cardiac medications (e.g. Eliquis, Entresto, Jardiance) between November 4, 2024 – May 31, 2025. Interventions made by a non-TOC pharmacist, pregnant patients, and prisoners were excluded in this study. The primary outcome is overall 30-day readmission rate. Secondary outcomes include quantification and classification of TOC pharmacy interventions, patient assistance applications initiated and/or approved, percentage of prescriptions filled at discharge, and 30-day readmission cause.

Results: Overall, 186 patients were included in the pharmacist-led TOC intervention group and 79 patients were included in the non-TOC intervention group. No significant difference was observed in rate of readmission within 30 days of discharge between TOC intervention and non-intervention groups (24% vs 20%, p=0.62). However, higher percentage of patients in the intervention group filled new high cost medication prescriptions at discharge (60% vs 47%, p=0.30), more medications were prescribed to meds-to-beds pharmacy (47% vs 32%, p=0.22), and patients in the TOC intervention group were less likely to be readmitted for medication related events (2% vs 12%, p=0.11).

Conclusions: No difference was observed in overall 30-day readmission rate between pharmacy-led TOC intervention group vs non-TOC intervention group. More providers prescribed new high-cost medications to Wellstar MCG Meds-to-Beds pharmacy, and a higher percentage of new prescriptions were dispensed at discharge with TOC pharmacist intervention. Additionally, patients were less likely to be readmitted for medication-related events in the TOC intervention group.