Observational studyInternational journal of clinical pharmacy2026
Association between unresolved drug-related problems and 6-month hospital readmissions following pharmacist-led medication reviews: a retrospective observational study.
Observational study in International journal of clinical pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionUnresolved drug-related problems may cause preventable medication-related harm and contribute to hospital readmissions. Comprehensive medication reviews conducted by clinical pharmacists are used to identify and address drug-related problems in hospital settings. However, the clinical relevance of drug-related problems that remain unresolved after identification, particularly in relation to hospital readmissions, remains unexplored.
aimTo examine the association between unresolved drug-related problems and 6-month all-cause hospital readmission, and to describe drug-related problem identification, intervention acceptance, and resolution during pharmacist-led comprehensive medication reviews.
methodA retrospective observational study was conducted in a tertiary hospital (2019-2022). Inpatients and outpatients referred by doctors for a pharmacist-led comprehensive medication review with ≥ 1 identified drug-related problem were included. The primary outcome was all-cause hospital readmission within 6 months following the medication review. Additional process measures included doctors' acceptance of pharmacists' recommendations, drug-related problem resolution status assessed based on follow-up documentation at 6 months, and the number of additional drug-related problems identified by pharmacists beyond those detected by doctors.
resultsA total of 177 patients undergoing 185 comprehensive medication reviews were included, in whom 505 drug-related problems were identified (mean 2.7 per review, standard deviation 2.0). Clinical pharmacists identified 73.9% of all drug-related problems and proposed interventions for 88.9% of them. Overall, 70.2% of pharmacists' recommendations were accepted by doctors. In a patient-level multivariable analysis adjusting for age, sex, comorbidities, medication count, total drug-related problem count, and the number of comprehensive medication reviews, the presence of any unresolved drug-related problems (OR = 4.02, 95% CI: 1.12-14.39, p = 0.033) and the number of unresolved drug-related problems (OR = 1.74, 95% CI: 1.10-2.74, p = 0.017) were independently associated with higher readmission risk, as was comorbidity count (OR = 1.47, 95% CI: 1.01-2.15, p = 0.046).
conclusionIn this retrospective study, the presence of unresolved drug-related problems following pharmacist-led comprehensive medication reviews was independently associated with four-fold higher odds of hospital readmission within 6 months. These findings highlight unresolved drug-related problems as a strong, independent marker of increased readmission risk. Prospective studies are needed to determine whether interventions that successfully resolve DRPs can causally reduce readmissions.
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