Evaluating pharmacy high-needs criteria: a tool for identifying inpatients at risk of medication-related problems

Abstract

Due to the high cost of clinical pharmacy services, vulnerable patients should be given priority in healthcare systems with limited resources.
For our healthcare system, this meant formulating high-needs pharmacy criteria to identify those patients who would benefit most from
clinical pharmacy care. To assess the efficacy of the high-needs pharmacy criteria in identifying patients at elevated risk of medication-related
poor clinical outcomes, a retrospective research was conducted on 761 patients admitted to four hospitals in metropolitan Melbourne. The
medical histories of potential high-needs patients were examined. The computerized data were mined for information on patient stays, 30-
day readmission rates, medication issues, and medication-related occurrences. Patients who met at least one high-needs criterion were in the
hospital longer (mean 6.7 days vs 3.1 days, p 0.01), were more likely to be readmitted within 30 days (27% vs 16%, p 0.01), and had a greater
incidence of medication-related issues (15% vs 7.6%, p 0.01). Patients with medication issues, medication events, or readmission within 30
days were detected with a sensitivity of over 80% using the high-needs criterion. Overall, the high-needs pharmacy criteria successfully
identified older patients with longer lengths of stay who are at increased risk for 30-day readmission and medication-related issues.