Abstract: SA-PO328
Coordination of Pharmaceutical Care in Dialysis Patients Is Associated With Lower Hospital Admission Rates
Session Information
- Hemodialysis and Frequent Dialysis: Potpourri
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Hart, David, FreseniusRx, Franklin, Tennessee, United States
- Chaudhuri, Sheetal, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Fox, Terrell W., FreseniusRx, Franklin, Tennessee, United States
- Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background
It is estimated in the literature that >50% of ESRD patients do not take their phosphate binders as prescribed. The renal pharmacy FreseniusRx provides coordinated mineral and bone disorder (MBD) medication delivery and adherence support for enrolled patients. We investigated whether coordinated MBD pharmaceutical care is associated with improvements in hospital admission in dialysis patients.
Methods
We included all hemodialysis patients who received >=2 BMM shipments from FreseniusRx pharmacy in Q1 and Q2 2018 and did not have any shipments from FreseniusRx in 2 years prior to 1/1/2018.We identified control patients not enrolled in the pharmacy by nearest neighbor 1:1 matching on the logit of the propensity score for demographics, comorbidities, state, insurance type, as well as, baseline lab values, vintage, treatment rates and hospitalization rates in baseline period, and hospital admission rate in 1 year prior to enrollment. We compared hospital admission rates in 6 and 12 months after the end of Q2 2018. Then the same analysis was repeated for Q1-Q2 2019.
Results
For the Q1-Q2 2018 analysis, we analyzed data on 16898 patients (8449 in Rx and 8449 matched patients not in Rx). Rx patients had lower hospital admission rates per patient year (non-Rx vs Rx at 6 and 12 months: 1.63 vs 1.53, 1.68 vs 1.63). For the Q1-Q2 2019 analysis, we analyzed data on 12184 patients (6092 in Rx and 6092 matched patients not in Rx). Rx patients had lower hospital admission rates per patient year (non-Rx vs Rx at 6 and 12 months: 1.64 vs 1.55, 1.59 vs 1.46).
Conclusion
Coordinated pharmaceutical care is associated with lower hospital admission in the hemodialysis patient population. Further analyses are needed to understand the outstanding characteristics of the pharmaceutical patient population and what elements of this coordinated care are associated with improvements.
Funding
- Commercial Support –