Pharmacist-led medication education groups on an inpatient psychiatric unit—Impact on readmissions and emergency department visits

Introduction: The optimal mechanism for delivery of medication education by pharmacists in the inpatient setting is unclear. Objectives: To evaluate the impact of pharmacist-led patient medication education groups (PMEGs) conducted in an inpatient psychiatry unit and to further delineate factors associated with psychiatric rehospitalization. Methods: A retrospective cohort study of 593 individual admissions in which PMEG attenders (n = 298) participated in one or more medication education sessions. The pharmacist leader served as moderator and utilized a motivational interviewing approach. PMEG nonattenders (n = 285) received usual care. Binomial logistic analyses and multiple linear regression analysis were used to identify factors associated with 90-day and 12-month psychiatric readmission, 12-month medical hospitalization, 12-month emergency department (ED) visits for psychiatric reasons, and time to psychiatric readmission. Results: After controlling for multiple factors, attendance at a single PMEG session was not associated with a reduction in any of the above outcomes. Attendance at two or more PMEG sessions was associated with a reduction in ED visits for psychiatric reasons (P = 0.0433). For each additional diagnosis, odds of a 90-day psychiatric readmission rose by a factor of 1.4. Patients prescribed antipsychotic or hypnotic medications were 2.4 and 2.5 times, respectively, more likely to experience 90-day psychiatric readmission. PMEG attendance did not lower the readmission risk for these high risk patients. Conclusion: A single PMEG intervention for psychiatric inpatients was not effective in reducing psychiatric readmission, but patients who participated in two or more PMEGs had fewer ED visits than those who attended only one PMEG. Additional research is needed regarding PMEG impacts on medication knowledge and attitude, as well as other potential reasons for psychiatric health care utilization.