Research Summary

Pharmacist-Led Transition Program Significantly Reduces Repeat Emergency Visits for Medication-Related Events

Kate Young

Key Highlights:

  • Pharmacist-led intervention reduced repeat emergency department visits for the same event from 22.1% to 3.0%.
  • Hospitalizations for the same medication-related event were also significantly lower in the intervention group.
  • Increased engagement with general practitioners and specialists was observed.


A pharmacist-led transition of care intervention in the emergency department (ED) led to a reduction in repeat visits for medication-related events, according to findings published in JAMA Internal Medicine. The study, conducted at Montpellier University Hospital in Montpellier, France, assessed whether targeted pharmacist involvement could improve continuity of care and reduce subsequent medication-related harms after an initial ED visit.

This prospective, open-label, parallel-group randomized clinical trial enrolled 330 adult patients presenting to the ED for a medication-related event (MRE) between November 2018 and July 2021. MREs included adverse drug reactions, medication misuse, and nonadherence resulting in clinical deterioration. Participants were randomly assigned to receive either standard care or a pharmacist-led transition program.

In the usual care group, pharmacists performed a standard medication history during the ED visit. In the intervention group, pharmacists additionally communicated with the patient’s general practitioner (GP) and community pharmacist after discharge—by both telephone and written correspondence—detailing the MRE type, suspected medication, and management recommendations. Outcomes were assessed by blinded evaluators, with data analysis conducted from January 2022 to March 2024.

Study Findings

At 6 months, patients who received the pharmacist-led transition of care intervention had fewer repeat ED visits for the same MRE compared with those receiving usual care (3.0% vs 22.1%; risk difference [RD], −19.1 percentage points; 95% CI, −26.0 to −12.2; P < .001). All-cause ED visits were also lower among intervention participants (21.0% vs 35.0%; RD, −14.0 percentage points; 95% CI, −23.6 to −4.4).

Hospitalizations related to the same MRE were substantially reduced in the intervention group (1.8% vs 17.8%; RD, −16.0 percentage points; 95% CI, −22.2 to −9.8). In contrast, participants receiving the intervention had higher rates of follow-up with GPs (55.7% vs 17.8%) and specialists (42.4% vs 24.0%) regarding their medication-related issues. All-cause hospitalizations and mortality were similar between groups.

Clinical Implications

The study demonstrates that structured pharmacist communication with outpatient care providers following an ED visit for an MRE can meaningfully reduce repeat drug-related ED visits and hospitalizations. By facilitating better information sharing between emergency and community care, this model could strengthen medication safety and improve postdischarge management for high-risk patients. The findings suggest that integrating clinical pharmacists into transitional care pathways may help reduce preventable drug-related harms and healthcare utilization.

Expert Commentary

“A targeted pharmacist-led transition of care intervention for patients presenting to the emergency department with a medication-related event led to a large reduction in subsequent medication-related emergency visits,” the researchers concluded.

Reference:
Gimenez P, et al. Effect of a Pharmacist-Led Transition of Care Intervention on Medication-Related Emergency Department Visits: A Randomized Clinical Trial. JAMA Intern Med. Published online November 11, 2024. doi:10.1001/jamainternmed.2024.6159