2026 Eastern States Conference

Title: Impact of a Transitions of Care Pharmacist Program on Reducing Hospital Readmissions in Patients Initiated on Subcutaneous Insulin at Discharge 

Authors: Christina Le, PharmD; Allison Chow, PharmD; Ryan Nguyen, PharmD

Presentation Objective: At the conclusion of my presentation, the participants will be able to describe the types of interventions a transition of care pharmacist can perform. 

Self-Assessment Question: (True/False) One of the types of intervention a transitions of care pharmacist can perform is clarifying a prescription of a medication prior to discharge. 

Objectives: This study aims to evaluate if pharmacist-led interventions improve transitions of care (TOC) by reducing hospital readmissions in patients newly initiated on insulin therapy. 
 
Methods: This retrospective study reviewed charts of patients ≥18 years with type 2 diabetes during two sequential 6-month periods. The standard-of-care prior to TOC implementation group included patients discharged between January–June 2023, and the TOC implementation group included patients discharged between January–June 2024. Eligible patients had no documented insulin use within the prior two years. In the TOC group, patients were included if there is documentation of TOC pharmacist insulin education. Baseline demographics and clinical characteristics were summarized descriptively and compared between groups. The primary outcome was 30-day hospital readmission rate defined as at least one readmission to any Hackensack Meridian Health hospital. Secondary outcomes included 90-day hospital readmission rate, median change in A1C, and the proportion of patients who have documented follow-up A1C within 6 months. Tertiary outcomes included the type of intervention documented by TOC pharmacists.

Results: Thirty-day readmission rates were not statistically significant between the standard-of-care and the TOC implementation group (2.1% vs 7.7%, p=0.321). Although the TOC implementation group demonstrated a higher rate of 30-day readmission rate compared to the standard of care group (OR: 4.17, 95% CI 0.43-93.7; p=0.25), the estimate was imprecise and not statistically significant. Sex, baseline A1C, and completion of follow-up A1C testing within 3–6 months were not associated with 30-day readmission (all p>0.40). 
 
Conclusion: Patients initiated on subcutaneous insulin therapy prior to discharge, both before and after implementation of the TOC pharmacy service, did not demonstrate a difference in 30-day readmission rates. These findings should be interpreted cautiously given the small sample size and wide confidence intervals. Additional studies are needed to further evaluate the impact of the TOC pharmacy service on readmissions.