Impact of delayed prescription fill on readmission rates for chronic obstructive pulmonary disease and heart failure.

Objectives: In an effort to reduce reimbursement penalty from the Centers for Medicare & Medicaid Services, hospitals have looked to evaluate the effectiveness of existing programs as well as adopt innovative practices to reduce 30-day readmission rates. The objective of this study was to evaluate the impact of delaying prescription fill on 30-day readmission rates for patients with heart failure (HF) and chronic obstructive pulmonary disease (COPD). Identifying an association between delaying prescription fill and readmission rate would validate programs that provide patients with their medications before discharge.

Methods: A retrospective chart review was performed for all patients admitted to Henry County Medical Center with an HF or COPD exacerbation from January to October 2016. Outpatient pharmacies were contacted for each patient to determine time of prescription fill. Time of fill was compared with time of discharge, and patients were separated into 2 subgroups: those who filled within 48 hours of discharge and those who filled after 48 hours. The primary outcome was 30-day readmission rate, and a secondary end point was to identify patient characteristics associated with delayed prescription fills.

Results: A total of 104 patients were included in the study. COPD patients experienced a lower readmission rate when delaying prescription fill at least 48 hours (P = 0.23). HF patients experienced a higher readmission rate when delaying prescription fill at least 48 hours (P = 0.48). No baseline characteristics were associated with a significantly higher rate of delaying prescription fill.

Conclusion: Delaying discharge prescription fills resulted in a nonsignificant increase in the rate of HF readmission but did not increase the rate of readmission for COPD. Rate of delaying prescription fill was not statistically greater for any of the baseline characteristics.