Evidence map›Paper›PMID 26883526›Full record

Trial reportJournal of general internal medicine2016

Effect of Pharmacist Counseling Intervention on Health Care Utilization Following Hospital Discharge: A Randomized Control Trial.

Susan P Bell, Jeffrey L Schnipper, Kathryn Goggins, Aihua Bian, Ayumi Shintani, Christianne L Roumie, Anuj K Dalal, Terry A Jacobson, Kimberly J Rask, Viola Vaccarino and 6 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 8 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 8 syntheses or guidelines pooled it, 87 citations in OpenAlex.

  1. Pooled it
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  4. Discharge planning from hospital.The Cochrane database of systematic reviews · 2022
    Pooled it
  5. Reducing medication errors for adults in hospital settings.The Cochrane database of systematic reviews · 2021
    Pooled it
  6. Disease management interventions for heart failure.The Cochrane database of systematic reviews · 2019
    Pooled it
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  8. Discharge planning from hospital.The Cochrane database of systematic reviews · 2016
    Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 4 institutions in 1 country.

Susan P BellVanderbilt Center for Translational and Clinical Cardiovascular Research (VTRACC), Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University, Suite 300-A 2525 West End Avenue, Nashville, TN, 37232-8300, USA. susan.p.bell@vanderbilt.edu.
Jeffrey L SchnipperHospitalist Service, Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Kathryn GogginsCenter for Health Services Research, Vanderbilt University, Nashville, TN, USA.
Aihua BianDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Ayumi ShintaniDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Christianne L RoumieCenter for Health Services Research, Vanderbilt University, Nashville, TN, USA.
Anuj K DalalHospitalist Service, Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Terry A JacobsonHospitalist Service, Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Kimberly J RaskDepartment of Epidemiology, Rollins School of Public Health, and Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA.
Viola VaccarinoDepartment of Epidemiology, Rollins School of Public Health, and Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA.
Tejal K GandhiNational Patient Safety Foundation, Boston, MA, USA.
Stephanie A LabonvilleDepartment of Pharmacy Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Daniel JohnsonVanderbilt University, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN, USA.
Erin B NealVanderbilt University, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN, USA.
Sunil KripalaniCenter for Health Services Research, Vanderbilt University, Nashville, TN, USA.
Pharmacist Intervention for Low Literacy in Cardiovascular Disease (PILL-CVD) Study Group
Brigham and Women's Hospital · USVanderbilt University · USEmory University · USVanderbilt University Medical Center · US

Funding

Building Interdisciplinary Research Careers in Women's HealthK12HD043483 · NICHD · VANDERBILT UNIVERSITY MEDICAL CENTER · PI HARTMANN, KATHERINE E, MAJOR, AMY S · 2002 to 2023
$10.3M
Vanderbilt Center for Diabetes Translation ResearchP30DK092986 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI OSBORN, CHANDRA Y. · 2011 to 2020
$6.7M
Mind-Body Interactions in Cardiovascular DiseaseK24HL077506 · NHLBI · EMORY UNIVERSITY · PI VACCARINO, VIOLA · 2004 to 2013
$1.5M
Using Information Systems to Improve Cardiac PreventionK08HL072806 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SCHNIPPER, JEFFREY LAWRENCE · 2003 to 2007
$669k
Training in Medication Compliance and Health LiteracyK23HL077597 · NHLBI · VANDERBILT UNIVERSITY · PI KRIPALANI, SUNIL · 2004 to 2008
$636k
Longitudinal Hemodynamic and Vascular Changes associated with FrailtyK23AG048347 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BELL, SUSAN POTTER · 2015 to 2016
$345k
NHLBI NIH HHS 2K24 HL077506NHLBI NIH HHS K08 HL072806NHLBI NIH HHS K23 HL077597NHLBI NIH HHS R01 HL989755NIA NIH HHS K23 AG048347NICHD NIH HHS K12 HD043483NICHD NIH HHS K12HD043483-11NIDDK NIH HHS P30 DK092986
6 · The paper itself

Abstract

backgroundReduction in 30-day readmission rates following hospitalization for acute coronary syndrome (ACS) and acute decompensated heart failure (ADHF) is a national goal.

objectiveThe aim of this study was to determine the effect of a tailored, pharmacist-delivered, health literacy intervention on unplanned health care utilization, including hospital readmission or emergency room (ER) visit, following discharge.

designRandomized, controlled trial with concealed allocation and blinded outcome assessors

settingTwo tertiary care academic medical centers

participantsAdults hospitalized with a diagnosis of ACS and/or ADHF.

interventionPharmacist-assisted medication reconciliation, inpatient pharmacist counseling, low-literacy adherence aids, and individualized telephone follow-up after discharge MAIN MEASURES: The primary outcome was time to first unplanned health care event, defined as hospital readmission or an ER visit within 30 days of discharge. Pre-specified analyses were conducted to evaluate the effects of the intervention by academic site, health literacy status (inadequate versus adequate), and cognition (impaired versus not impaired). Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) are reported. KEY

resultsA total of 851 participants enrolled in the study at Vanderbilt University Hospital (VUH) and Brigham and Women's Hospital (BWH). The primary analysis showed no statistically significant effect on time to first unplanned hospital readmission or ER visit among patients who received interventions compared to controls (aHR = 1.04, 95% CI 0.78-1.39). There was an interaction of treatment effect by site (p = 0.04 for interaction); VUH aHR = 0.77, 95% CI 0.51-1.15; BWH aHR = 1.44 (95% CI 0.95-2.12). The intervention reduced early unplanned health care utilization among patients with inadequate health literacy (aHR 0.41, 95% CI 0.17-1.00). There was no difference in treatment effect by patient cognition.

conclusionA tailored, pharmacist-delivered health literacy-sensitive intervention did not reduce post-discharge unplanned health care utilization overall. The intervention was effective among patients with inadequate health literacy, suggesting that targeted practice of pharmacist intervention in this population may be advantageous.

Indexed as

Acute Coronary SyndromeAdultAgedCounselingFemaleHealth LiteracyHeart FailureHumansMaleMedication ReconciliationMiddle AgedOutcome Assessment, Health CarePatient Acceptance of Health CarePatient DischargePatient Education as TopicPatient ReadmissionAcute coronary syndromeHealth literacyHeart failurePharmacistReadmissions

Identifiers

PMID26883526
PMCPMC4835388
OpenAlexW2279007518

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.