Mining Data to Improve Care Coordination of Patients with Hematologic Malignancies

Abstract

Purpose

The purpose of this study was to assess patient, disease, and medication-related factors that affect the rate of unplanned readmissions before next chemotherapy cycle or within 30 days since last chemotherapy admission in patients with hematologic malignancies.

Methods

This study is a retrospective chart review. All patients with leukemia, lymphoma, or multiple myeloma aged >18 years who received chemotherapy over a three-year period were evaluated.

Results

A total of 107 inpatient chemotherapy encounters and 47 patients were included. Of those encounters that led to readmission, 68.7 percent (n = 22/32, p = 0.2212) did not have medications filled prior to discharge, 78.1 percent (n = 25/32, p = 0.4026) did not receive a follow-up phone call, and 50 percent (n = 16/32, p = 0.0233) did not attend their follow-up appointment. In the readmission group, 9 patients had an adverse event (AE) and none were communicated upon discharge. In the not readmitted group, 34 had an AE and 15 were communicated upon discharge (100 percent vs. 44 percent; p = 0.0169).

Conclusions

Factors that contributed to readmission in this patient population include providers not communicating upon discharge whether the patient had an AE during treatment and patients not attending their follow-up appointment. There is a need to improve transitions of care coordination and communication in patients with hematologic malignancies.

Acknowledgment

Nilam Patel, PharmD, BCPS, is acknowledged for her contribution to this research project.

Disclosure Statement

The authors report no conflict of interest.

Additional information

Notes on contributors

Rachel Dragovich

Rachel Dragovich, PharmD, BCPS, is a lead clinical pharmacist specializing in Internal Medicine and Transitions of Care at Summa Health System, Akron, Ohio, and an assistant professor of Pharmacy Practice at Northeast Ohio Medical University, Rootstown, Ohio. Jan Kover, RPh, BCOP, is a hematology/oncology specialist at the MetroHealth System, Cleveland, Ohio.

Jan Kover

Rachel Dragovich, PharmD, BCPS, is a lead clinical pharmacist specializing in Internal Medicine and Transitions of Care at Summa Health System, Akron, Ohio, and an assistant professor of Pharmacy Practice at Northeast Ohio Medical University, Rootstown, Ohio. Jan Kover, RPh, BCOP, is a hematology/oncology specialist at the MetroHealth System, Cleveland, Ohio.