The Association Between a Risk Assessment-Based Medication Safety Checklist and 90-Day Readmission Among Residents of Long-Term Care Institutions: A Pilot Quasi-Experimental Study.

AIM: Care transitions involve high risks for adverse drug events among residents of long-term care institutions. This pilot study aimed to investigate the association of a discharge Medication Safety Checklist-grounded in the 8 P risk-assessment framework-with readmission outcomes, specifically unplanned 90-day hospital readmission rates. METHODS: A two-arm, two-ward, nonrandomized cluster-allocated pilot quasi-experimental study enrolled 200 residents in a regional teaching hospital in central Taiwan (March-November 2024), with 100 in the intervention group receiving the checklist and 100 in the control group receiving standard care. Following the TREND reporting guidelines (see Supporting Information S1), data were analyzed using Cox proportional hazards regression as an exploratory individual-level analysis, with prespecified covariates to address individual-level confounders, acknowledging that ward-level confounding could not be formally adjusted due to the two-ward design. RESULTS: The intervention group had a 51.1% lower risk of 90-day readmission than the control group (HR = 0.489, 95% CI = 0.324-0.731). CONCLUSIONS: Implementation of a risk assessment-based medication safety checklist was associated with a lower risk of 90-day readmissions among residents of long-term care institutions. These preliminary findings suggest the feasibility of integrating high-risk medication identification with optimized transitional communication to enhance medication safety. However, as a pilot study, these results should be viewed as hypothesis-generating, and the observed associations require confirmation in future adequately powered, cluster-appropriate randomized studies.