Impact of warfarin discharge education program on hospital readmission and treatment costs

Luigi Brunetti, Seung Mi Lee, Nancy Doherty, David Suh, Jeong Eun Kim, Sun Hong Lee, Yong Chan Choi, Dong Churl Suh

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background Although warfarin is highly effective, management of patients prescribed warfarin is complex due to its narrow therapeutic window. Objective To evaluate the impact of a formal warfarin discharge education program (WDEP) on hospital readmission and treatment costs in patients who received warfarin therapy. Setting Robert Wood Johnson University Hospital Somerset in Somerville, New Jersey, USA. Method In this interventional cohort study, patients were assigned to either the WDEP group or the usual care group. The effects of the WDEP on readmission within 90 days after discharge were analyzed using Cox proportional hazards models. Factors influencing treatment cost were identified using generalized linear model with log-link function and gamma distribution. Main outcome measure Hospital readmission within 90 days and treatment costs associated with hospital readmission. Results Among 692 eligible patients, 203 in each group were matched using propensity scores and there were no statistically significant differences in the patient baseline characteristics between two groups. The risk of all-cause readmission within 90 days was significantly lower in the WDEP group compared to the usual care group (relative risk = 0.46, 95% CI 0.28–0.76). The treatment costs associated with hospital readmission in the WDEP group were 19% lower than those in the usual care group after adjusting for the study variables. Conclusion A formal, individualized WDEP provided by pharmacists resulted in significant reduction of readmission and treatment costs. The economic burden of treatment costs associated with warfarin can be controlled if well-organized warfarin education is provided to patients who received warfarin therapy.

Original languageEnglish (US)
Pages (from-to)721-729
Number of pages9
JournalInternational Journal of Clinical Pharmacy
Volume40
Issue number3
DOIs
StatePublished - Jun 1 2018

All Science Journal Classification (ASJC) codes

  • Pharmacy
  • Toxicology
  • Pharmacology
  • Pharmaceutical Science
  • Pharmacology (medical)

Keywords

  • Hospital discharge
  • Hospital readmission
  • Patient education
  • Pharmaceutical care
  • Treatment costs
  • USA
  • Warfarin education

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