Impact of Pharmacist-led Care Navigation Mediated by Digital Health Tools on Hospital Readmissions

Hospitalizations for Primary Care‐Sensitive Conditions (PCSCs) are potentially avoidablehospital admissions that may be prevented when Primary Health Care provides effective andtimely care through prevention, early diagnosis, appropriate management of chronicconditions, and control of acute episodes.This study proposes an open‐label, pragmatic, cluster‐randomized clinical trial toevaluate the effectiveness of continuous telecare, supported by digital health tools, inthe post‐discharge follow‐up of patients hospitalized for PCSCs.The main outcome will be the occurrence of non‐elective hospital readmissions and urgentor emergency care visits within 180 days after discharge, compared with usual care.The intervention will include pharmacist‐led teleconsultations, a communication channelthrough a messaging app, and the development of an individualized care plan. Participantsin the control group will receive the usual care provided by the healthcare network.