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reflection questions for the formulary administrator may
include the following: (1) whether introduction of new
generic options has changed the cost-benefit of a restricted
formulary and (2) whether a streamlined formulary which
results in a high volume of interchange increases provider
workload due to greater medication reconciliation requirements on admission and discharge. These questions,
although beyond the scope of the current study, warrant
future examination.

Conclusion
This retrospective cohort review was the first to examine the
potential effects of TI on patient outcomes following discharge from an inpatient setting. TI was shown to increase
the odds of medication changes at discharge, and the rates of
interchange and discharge medication changes varied widely
by drug class. Despite increasing the risk of discharge medication changes, TI did not affect hospital readmission rates
or emergency department visit rates after hospital discharge.
The long-term effectiveness and adverse drug event rates of
discharge medication changes which occurred as a result of
TI were not assessed in this study, but is worth examining in
the future to improve our understanding of the risks and benefits of TI. Despite these limitations, the present findings
support the general safety of TI in the hospital.
Authors' Note
Previous presentations of this work:
1.
Presentation of methods: Popp RA. Alcalde Southwest
Leadership Conference; April 5, 2018; The Woodlands, TX.
2.
Poster presentation of interim results: Popp RA. American
College of Clinical Pharmacy Global Conference on
Clinical Pharmacy; October 22, 2018, Seattle, WA.
3.
Presentation of results: Popp RA. Alcalde Southwest
Leadership Conference; April 10, 2019; The Woodlands,
TX.

Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs
Ryan A. Popp
https://orcid.org/0000-0002-5715-9042
Rebecca L. Attridge
https://orcid.org/0000-0003-2162-3285

Hospital Pharmacy 55(6)
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http://www.amaassn.org/resources/doc/csaph/a04csa2-fulltext.pdf http://www.amaassn.org/resources/doc/csaph/a04csa2-fulltext.pdf https://www.orcid.org/0000-0002-5715-9042 https://www.orcid.org/0000-0003-2162-3285

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