Table 4.

Summary of clinical pharmacist activities provided by the post-discharge clinical pharmacist in studies reporting 30-day hospital readmission and/or representations (n = 45).

Clinical pharmacist activity	Significant (n = 19)a		Not significant (n = 27)a
	Frequency	%	Frequency	%
Best possible medication history	7	37	8	30
Medication reconciliation (post-discharge)	10	53	18	67
Best possible medication discharge listb	1	5	2	7
Patient educationb	10	53	19	70
Discharge medication supply	0	0	1	4
Medication order review	8	42	9	33
Pharmaceutical (or medication) review	16	84	24	89
Interventions directed to inpatient physician	2	11	1	4
Interventions directed to primary care provider	12	63	13	48

^aRebello et al is represented as a study with both a significant (ED/urgent care visit) and not significant (30-day readmissions) outcome.

^bProvided as part of the post-discharge clinic pharmacist follow-up.