International Journal of Clinical Pharmacy

, Volume 35, Issue 1, pp 37–44 | Cite as

The effect of pharmacotherapeutic counseling on readmissions and emergency department visits

  • Srecko MarusicEmail author
  • Nives Gojo-Tomic
  • Viktorija Erdeljic
  • Vesna Bacic-Vrca
  • Miljenko Franic
  • Marijan Kirin
  • Velimir Bozikov
Research Article


Objective To evaluate the impact of pharmacotherapeutic counseling on the rates and causes of 30-day post-discharge hospital readmissions and emergency department visits. Setting The study was conducted at the Medical Clinic of University Hospital Dubrava, Zagreb, Croatia. Methods The study included elderly patients prescribed with two or more medications for the treatment of chronic diseases. The patients randomized into the intervention group received pre-discharge counseling by the clinical pharmacologist about each prescribed medication. The control group received no counseling. Main outcome measures The rates and causes of 30-day postdischarge hospital readmissions and emergency department visits. Medication compliance was also evaluated, using the pill count method. Results A total of 160 patients were randomly selected for the study. No significant difference was found in the readmission and emergency department visit rates between the intervention and control groups (p = 0.224). There were 34.9 % more compliant patients in the intervention group. Significantly more non-compliant patients in the control group were readmitted or visited emergency department because of the disease progression (p = 0.031). In the intervention group, significantly more patients were readmitted or visited emergency department because of an adverse drug reaction (p = 0.022). Conclusion Pharmacotherapeutic counseling can reduce readmission and emergency department visit rates for disease progression. Improved patient knowledge about adverse drug reactions could be the reason for increased rates of readmissions and emergency department visits due to adverse drug reactions in the intervention group.


Adverse drug reaction Compliance Croatia Emergency department visit Pharmacotherapeutic counseling Readmission 



We thank all patients for participating in the study.


The study received no external funding.

Conflicts of interest

None of the authors of this manuscript had any conflict of interests related to the study.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Srecko Marusic
    • 1
    Email author
  • Nives Gojo-Tomic
    • 1
  • Viktorija Erdeljic
    • 2
  • Vesna Bacic-Vrca
    • 3
  • Miljenko Franic
    • 4
  • Marijan Kirin
    • 5
  • Velimir Bozikov
    • 6
  1. 1.Department of Clinical PharmacologyUniversity Hospital DubravaZagrebCroatia
  2. 2.Department of Clinical PharmacologyUniversity Hospital ZagrebZagrebCroatia
  3. 3.Department of Clinical PharmacyUniversity Hospital DubravaZagrebCroatia
  4. 4.Department of Orthopedic SurgeryUniversity Hospital DubravaZagrebCroatia
  5. 5.Intensive Care UnitUniversity Hospital DubravaZagrebCroatia
  6. 6.Department of EndocrinologyUniversity Hospital DubravaZagrebCroatia

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