Terminated: Study halted prematurely and will not resume; participants are no longer being examined or receiving intervention. Lack of data to demonstrate sufficient power.

A study to demonstrate that the LACE+ score in non-inferior to the medication risk score when predicting 30-day readmission post hospital discharge.

The objective of this study is evaluate a program that provides transition of care services to a local Tucson hospital involving activities designed to reduce 30 day post hospital discharge readmission rates. The organization has had a fee for service contract with this hospital since 2017 to provide pharmacist delivered transition of care services. The organization collects internal tracking outcome data as part of the contract deliverable and is required to report it to the hospital once per month. The investigators look to assess LACE+ and medication risk scores to learn if there is an association with the 30 day post hospital discharge readmission rate post pharmacist intervention. The outcomes will not be generalizable and will be reported back to the hospital client to demonstrate value added.

Inclusion Criteria:

• Those referred to receive transition of care services between January 2018 to December 2019 and were discharged on 10 or more medications.

Exclusion Criteria:

• 89 years or older

Information will be collected from an internal data collection excel used to provide monthly outcome intervention reports to the local Tucson hospital.