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Harris M, Moore V, Barnes M, Persha H, Reed J, Zillich A. Effect of pharmacy-led interventions during care transitions on patient hospital readmission: A systematic review. J Am Pharm Assoc (2003) 2022; 62:1477-1498.e8. [PMID: 35718715 DOI: 10.1016/j.japh.2022.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Centers for Medicare and Medicaid (CMS) established the Hospital Readmissions Reduction Program (HRRP) to reduce reimbursement payments to hospitals with excessive patient readmissions. Because of this program, hospitals have developed transitions of care (TOC) programs to improve patient outcomes. OBJECTIVES To identify and uniformly summarize the impact of pharmacy-led TOC interventions on 30-day readmission rates since the implementation of CMS HRRP. METHODS This study followed an a-priori protocol that was registered to International Prospective Register of Systematic Reviews. A systematic search was conducted using PubMed, EMBASE, International Pharmaceutical Abstracts, and CINAHL from January 1, 2013 through January 14, 2022. Studies were included if they met the following criteria: pharmacy-led intervention, 30-day readmission outcomes, patients at least 18 years old, original research performed in the United States, and English language only articles. Descriptive statistics were used to summarize study characteristics, outcomes, and elements of the study interventions. RESULTS A total of 1964 abstracts were screened with 123 studies being included in the review. A total of 110 (89.4%) studies showed a decrease in readmission rates. The largest decrease in readmission rates was 44.5% (range 0.2%-44.5%, median = 7.4%) and the most common pharmacy-led intervention was patient counseling (n = 119, 96.7%) followed by medication reconciliation (n = 111, 90.2%). High-risk patient populations were commonly targeted with 52 studies (42.3%) focusing on CMS HRRP related diagnoses. CONCLUSION Most pharmacist-led TOC interventions contributed to lower rates of 30-day readmission. Future studies should investigate the types of interventions that most significantly impact readmission rates.
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Eudaley ST, Brooks SP, Jones MJ, Franks AS, Dabbs WS, Chamberlin SM. Evaluation of student-perceived growth in entrustable professional activities after involvement in a transitions-of-care process within an adult medicine advanced pharmacy practice experience. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:193-199. [PMID: 35190161 DOI: 10.1016/j.cptl.2021.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 11/09/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND PURPOSE Involvement of pharmacists and trainees in care transitions reduces medication-related problems. Participation in the transitions-of-care (TOC) process may impact self-perceived growth of autonomy within selected entrustable professional activities (EPAs). EDUCATIONAL ACTIVITY AND SETTING A student-driven TOC documentation process was implemented within an inpatient family medicine advanced pharmacy practice experience. During the month-long rotation, students rounded with an interdisciplinary care team. Responsibilities included ensuring accurate medication reconciliation at care transitions throughout hospitalization and prior to discharge as well as medication optimization during hospitalization. Another responsibility was completing a medication-specific TOC note in the clinic-based electronic health record at discharge for patients receiving primary care from the associated clinic. The note was available to the outpatient interdisciplinary care team during the hospital follow-up appointment. Student-perceived growth in autonomy within selected EPAs was determined through an online anonymous survey. FINDINGS Ninety percent (n = 18) of eligible students completed the survey. For specific EPA statements (collecting information, establishing patient-centered goals and establishing a care plan, implementing a care plan, collaborating as an interdisciplinary team member, and ensuring immunization), student-perceived autonomy increased after involvement in this student-driven TOC process. During the study period, 215 notes were generated by student pharmacists and included interventions/recommendations within the following themes: evidence-based changes in therapy, patient counseling, and medication access. SUMMARY The importance of pharmacist and pharmacy trainee involvement in the TOC process has been well-documented. Involving students in student-driven TOC documentation processes serves to facilitate student-perceived growth in autonomy within selected EPAs.
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Affiliation(s)
- Sarah T Eudaley
- Assistant Professor, Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, College of Pharmacy 1924 Alcoa Hwy, Box 117, Knoxville, TN 37920, United States.
| | - Shelby P Brooks
- Clinical Assistant Professor, University of Louisiana, Monroe College of Pharmacy, Shreveport Campus 400 Texas Street, Suite 1000, Shreveport, LA 71101, United States.
| | - Maura J Jones
- Assistant Professor, Pharmacy Practice Midwestern University College of Pharmacy, Glendale, Campus 19555 N. 59(th) Avenue Glendale, AZ 85308, United States.
| | - Andrea S Franks
- Professor, Department of Clinical Pharmacy, Translational Science University of Tennessee Health Science Center, College of Pharmacy 1924 Alcoa Hwy, Box 117, Knoxville, TN 37920, United States.
| | - William S Dabbs
- Assistant Professor & Clerkship Director Family Medicine, University of Tennessee, Graduate School of Medicine, 1924 Alcoa Highway, Box U-67, Knoxville, TN 37920, United States.
| | - Shaunta M Chamberlin
- Professor of Family Medicine, University of Tennessee, Graduate School of Medicine, 1924 Alcoa Highway, Box U-67, Knoxville, TN 37920, United States.
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Varghese S, Hahn-Goldberg S, Deng Z, Bradley-Ridout G, Guilcher SJT, Jeffs L, Madho C, Okrainec K, Rosenberg-Yunger ZRS, McCarthy LM. Medication Supports at Transitions Between Hospital and Other Care Settings: A Rapid Scoping Review. Patient Prefer Adherence 2022; 16:515-560. [PMID: 35241910 PMCID: PMC8887864 DOI: 10.2147/ppa.s348152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 01/24/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Transitions in care (TiC) often involves managing medication changes and can be vulnerable moments for patients. Medication support, where medication changes are reviewed with patients and caregivers to increase knowledge and confidence about taking medications, is key to successful transitions. Little is known about the optimal tools and processes for providing medication support. This study aimed to identify describe patient or caregiver-centered medication support processes or tools that have been studied within 3 months following TiC between hospitals and other care settings. METHODS Rapid scoping review; English-language publications from OVID MEDLINE, OVID EMBASE, Cochrane Library and EBSCO CINAHL (2004-July 2019) that assessed medication support interventions delivered within 3 months following discharge were included. A subset of titles and abstracts were assessed by two reviewers to evaluate agreement and once reasonable agreement was achieved, the remainder were assessed by one reviewer. Eligibility assessment for full-text articles and data charting were completed by an experienced reviewer. RESULTS A total of 7671 unique citations were assessed; 60 studies were included. Half of the studies (n = 30/60) were randomized controlled trials. Most studies (n = 45/60) did not discuss intervention development, particularly whether end users were involved in intervention design. Many studies (n = 37/60) assessed multi-component interventions with written/print and verbal education components. Few studies (n = 5/60) included an electronic component. Very few studies (n = 4/60) included study populations at high risk of adverse events at TiC (eg, people with physical or intellectual disabilities, low literacy or language barriers). CONCLUSION The majority of studies were randomized controlled trials involving verbal counselling and/or physical document delivered to the patient before discharge. Few studies involved electronic components or considered patients at high-risk of adverse events. Future studies would benefit from improved reporting on development, consideration for electronic interventions, and improved reporting on patients with higher medication-related needs.
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Affiliation(s)
- Shawn Varghese
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Michael G.Degroote School Of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Shoshana Hahn-Goldberg
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- OpenLab, University Health Network, Toronto, Ontario, Canada
| | - ZhiDi Deng
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Glyneva Bradley-Ridout
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Lianne Jeffs
- Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Sinai Health, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Craig Madho
- OpenLab, University Health Network, Toronto, Ontario, Canada
| | - Karen Okrainec
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Zahava R S Rosenberg-Yunger
- Ted Rogers School of Management, School of Health Services Management, Ryerson University, Toronto, Ontario, Canada
| | - Lisa M McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Correspondence: Lisa M McCarthy, Clinician Scientist, Institute for Better Health, Trillium Health Partners, Tel +1 416-566-2793, Email
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King PK, Burkhardt C, Rafferty A, Wooster J, Walkerly A, Thurber K, Took R, Masterson J, St. Peter WL, Furuno JP, Williams E, Ferren J, Rascon K. Quality measures of clinical pharmacy services during transitions of care. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | | | | | | | | | | | - Roxane Took
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | - Jon P. Furuno
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Evan Williams
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Janie Ferren
- American College of Clinical Pharmacy Lenexa Kansas USA
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Gabriel C, Bedi R, Coley KC, Richardson RM, Somma McGivney MA, Baumgartner MA, Vercammen V, Carroll JC. Informing the development of a transitions of care program between an emergency department and regional supermarket chain pharmacies. J Am Pharm Assoc (2003) 2021; 61:S78-S84. [PMID: 33531263 DOI: 10.1016/j.japh.2020.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/15/2020] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Pharmacist collaboration in transitions of care (TOC) programs is integral to increase patient education and adherence after discharge. This study aimed to conduct a qualitative evaluation of stakeholder perspectives to inform the design and implementation of a TOC program between an emergency department (ED) and regional supermarket chain pharmacies. METHODS Pharmacies from a regional supermarket chain were identified for inclusion on the basis of geographic proximity to a local community hospital ED. Semistructured, one-on-one interviews with the primary investigator were conducted. Interview questions were based on the Consolidation Framework for Implementation Research (CFIR). The following 5 CFIR domains were used: (1) intervention characteristics, (2) outer setting, (3) inner setting, (4) characteristics of individuals, and (5) process. Interviews were audio-recorded and transcribed. Two investigators coded each transcript independently. A thematic analysis was performed. RESULTS A total of 19 interviews were conducted, and the following 7 major themes emerged on analysis: (1) enhance real-time interprofessional communication, (2) establish data sharing between the ED and the community pharmacy, (3) provide timely resolution of prescription insurance issues for new therapies post-ED discharge, (4) use off-site pharmacy resources to support community pharmacy workflow, (5) increase patient education to prevent primary medication nonadherence, (6) reinforce discharge care plans, and (7) focus on community-dwelling older adult patients in an ED care transition program. CONCLUSION Health care providers including pharmacists, physicians, nurses, and care managers, view an ED-to-community pharmacy TOC program as a valuable service to increase patient education on new medications and discharge planning. Establishment of data sharing and reimbursement is integral to the development, implementation, and sustainability of such programs. There is an untapped opportunity for community pharmacists to bridge the gap in care after ED discharge.
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Mohammad RA, Betthauser KD, Korona RB, Coe AB, Kolpek JH, Fritschle AC, Jagow B, Kenes M, MacTavish P, Slampak‐Cindric AA, Whitten JA, Jones C, Simonelli R, Rowlands I, Stollings JL. Clinical pharmacist services within intensive care unit recovery clinics: An opinion of the critical care practice and research network of the American College of Clinical Pharmacy. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2020. [DOI: 10.1002/jac5.1311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Rima A. Mohammad
- Department of Clinical Pharmacy University of Michigan College of Pharmacy Ann Arbor Michigan USA
| | - Kevin D. Betthauser
- Department of Pharmacy Services Barnes‐Jewish Hospital Saint Louis Missouri USA
| | | | - Antoinette B. Coe
- Department of Clinical Pharmacy University of Michigan College of Pharmacy Ann Arbor Michigan USA
| | | | | | - Benjamin Jagow
- Department of Pharmacy MercyOne Des Moines Medical Center Des Moines Iowa USA
| | - Michael Kenes
- Department of Clinical Pharmacy University of Michigan College of Pharmacy Ann Arbor Michigan USA
| | | | | | | | - Carol Jones
- Department of Pharmacy Guy's and St. Thomas' NHS Foundation Trust London UK
| | | | - Ian Rowlands
- Department of Pharmacy Barts Health NHS Trust London UK
| | - Joanna L. Stollings
- Department of Pharmacy and Critical Illness Brain Dysfunction, Survivorship (CIBS) Center, Vanderbilt University Medical Center Nashville Tennessee USA
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Cheon O, Baek J, Kash BA, Jones SL. An exploration of community partnerships, safety-net hospitals, and readmission rates. Health Serv Res 2020; 55:531-540. [PMID: 32249423 DOI: 10.1111/1475-6773.13287] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare hospital-community partnerships among safety-net hospitals relative to non-safety-net hospitals, and explore whether hospital-community partnerships are associated with reductions in readmission rates. DATA SOURCES Data from four nationwide hospital-level datasets for 2015-2016, including American Hospital Association (AHA) annual survey, Hospital Inpatient Prospective Payment System (IPPS) data, CMS Hospital Compare, and County Health Rankings National (CHRN) data. STUDY DESIGN We first examined how safety-net hospitals partner with nine different community providers, and how the overall and individual partnership patterns differ from those in non-safety-net hospitals. We then explored their association with 30-day readmission rates by diagnosis and hospital wide. DATA COLLECTION/EXTRACTION METHODS We included 1979 hospitals across 50 US states. PRINCIPAL FINDINGS Safety-net hospitals were more engaged in hospital-community partnerships, especially with local public health, local governments, social services, nonprofits, and insurance companies, relative to their non-safety-net peers. However, we found that such partnerships were not significantly related to reductions in readmission rates. The findings indicated that merely partnering with various community organizations may not be associated with readmission rate reduction. CONCLUSIONS Before promoting partnerships with various community organizations for its own sake, further prospective, longitudinal, and evidence-based guidance derived from the study of hospital-community partnerships is needed to make meaningful recommendations aimed at readmission rate reduction in safety-net hospitals.
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Affiliation(s)
- Ohbet Cheon
- David D. Reh School of Business, Clarkson University, Schenectady, New York.,Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas
| | - Juha Baek
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas.,School of Public Health, Texas A&M University, College Station, Texas
| | - Bita A Kash
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas.,School of Public Health, Texas A&M University, College Station, Texas.,NSF Center for Health Organization Transformation, Texas A&M University, College Station, Texas
| | - Stephen L Jones
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas.,Weill Cornell Medical College, Cornell University, New York, New York
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Stranges PM, Jackevicius CA, Anderson SL, Bondi DS, Danelich I, Emmons RP, Englin EF, Hansen ML, Nys C, Phan H, Philbrick AM, Rager M, Schumacher C, Smithgall S. Role of clinical pharmacists and pharmacy support personnel in transitions of care. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2020. [DOI: 10.1002/jac5.1215] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | | | - Ilya Danelich
- American College of Clinical Pharmacy; Lenexa Kansas
| | | | | | | | - Cara Nys
- American College of Clinical Pharmacy; Lenexa Kansas
| | - Hanna Phan
- American College of Clinical Pharmacy; Lenexa Kansas
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Renfro CP, Robinson JM, Turner K, Gaskins T, Ferreri SP. Care coordination and follow-up practices in the community pharmacy setting: A mixed methods study. J Am Pharm Assoc (2003) 2020; 60:631-638.e2. [PMID: 31919008 DOI: 10.1016/j.japh.2019.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/18/2019] [Accepted: 11/21/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This mixed methods study had 2 aims: (1) to describe the frequency of care coordination between pharmacists, prescribers, and care managers and (2) to identify pharmacists' strategies for care coordination and follow-up in a community pharmacy setting. DESIGN This study used a mixed methods design. SETTING AND PARTICIPANTS Pharmacists who were responsible for implementing North Carolina community pharmacy enhanced services network (NC CPESN®) activities in their pharmacy during the first or second year of the 3-year program (September 2014-August 2016). OUTCOME MEASURES A survey was administered to gather data on care coordination in community pharmacies and for follow-up. In-depth interviews were conducted to expand on the findings from the quantitative data. Descriptive statistics were calculated for survey data. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis. RESULTS Surveys were received from 101 pharmacies (82.1% response rate). Fourteen pharmacies with missing responses were removed, resulting in 87 pharmacies being included in the analysis. The majority of pharmacies were single, independent pharmacies (46.5%), and approximately one-third of pharmacies had a clinical pharmacist on the staff (31.1%). To communicate with prescribers, pharmacists most frequently used facsimile (fax) (82.1%) or phone (65.5%). A total of 12 pharmacists participated in the semistructured interviews. Pharmacists defined care coordination as interdisciplinary collaboration and communication among the members of the health care team to provide the best possible patient-centered care. All pharmacists agreed that good health care provider (i.e., care manager and prescriber) relationships are crucial to the success of patient care; however, participants mentioned that building these relationships has been or is currently difficult to establish. CONCLUSION Care coordination among pharmacists, prescribers, and care managers is important for improving patients' medication management and overall outcomes. To our knowledge, this is the first study to quantify care coordination between pharmacists, prescribers, and care managers and to identify strategies to facilitate care coordination. Results from this study have the potential to inform how care coordination and longitudinal follow-up are best implemented within the community pharmacy setting.
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The impact of community pharmacist involvement on transitions of care: A systematic review and meta-analysis. J Am Pharm Assoc (2003) 2020; 60:153-162.e5. [DOI: 10.1016/j.japh.2019.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/13/2019] [Accepted: 07/02/2019] [Indexed: 11/18/2022]
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Bloodworth LS, Malinowski SS, Lirette ST, Ross LA. Pharmacist linkage in care transitions: From academic medical center to community. J Am Pharm Assoc (2003) 2019; 59:896-904. [DOI: 10.1016/j.japh.2019.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 08/02/2019] [Accepted: 08/25/2019] [Indexed: 11/27/2022]
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The Impact of Pharmacy-specific Predictors on the Performance of 30-Day Readmission Risk Prediction Models. Med Care 2019; 57:295-299. [PMID: 30829940 DOI: 10.1097/mlr.0000000000001075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
RESEARCH OBJECTIVE Pharmacists are an expensive and limited resource in the hospital and outpatient setting. A pharmacist can spend up to 25% of their day planning. Time spent planning is time not spent delivering an intervention. A readmission risk adjustment model has potential to be used as a universal outcome-based prioritization tool to help pharmacists plan their interventions more efficiently. Pharmacy-specific predictors have not been used in the constructs of current readmission risk models. We assessed the impact of adding pharmacy-specific predictors on performance of readmission risk prediction models. STUDY DESIGN We used an observational retrospective cohort study design to assess whether pharmacy-specific predictors such as an aggregate pharmacy score and drug classes would improve the prediction of 30-day readmission. A model of age, sex, length of stay, and admission category predictors was used as the reference model. We added predictor variables in sequential models to evaluate the incremental effect of additional predictors on the performance of the reference. We used logistic regression to regress the outcomes on predictors in our derivation dataset. We derived and internally validated our models through a 50:50 split validation of our dataset. POPULATION STUDIED Our study population (n=350,810) was of adult admissions at hospitals in a large integrated health care delivery system. PRINCIPAL FINDINGS Individually, the aggregate pharmacy score and drug classes caused a nearly identical but moderate increase in model performance over the reference. As a single predictor, the comorbidity burden score caused the greatest increase in model performance when added to the reference. Adding the severity of illness score, comorbidity burden score and the aggregate pharmacy score to the reference caused a cumulative increase in model performance with good discrimination (c statistic, 0.712; Nagelkerke R, 0.112). The best performing model included all predictors: severity of illness score, comorbidity burden score, aggregate pharmacy score, diagnosis groupings, and drug subgroups. CONCLUSIONS Adding the aggregate pharmacy score to the reference model significantly increased the c statistic but was out-performed by the comorbidity burden score model in predicting readmission. The need for a universal prioritization tool for pharmacists may therefore be potentially met with the comorbidity burden score model. However, the aggregate pharmacy score and drug class models still out-performed current Medicare readmission risk adjustment models. IMPLICATIONS FOR POLICY OR PRACTICE Pharmacists have a great role in preventing readmission, and therefore can potentially use one of our models: comorbidity burden score model, aggregate pharmacy score model, drug class model or complex model (a combination of all 5 major predictors) to prioritize their interventions while exceeding Medicare performance measures on readmission. The choice of model to use should be based on the availability of these predictors in the health care system.
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Systematic Review and Meta-analysis of Pharmacist-Led Transitions of Care Services on the 30-Day All-Cause Readmission Rate of Patients with Congestive Heart Failure. Clin Drug Investig 2019; 39:703-712. [DOI: 10.1007/s40261-019-00797-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Improving care transitions through medication therapy management: A community partnership to reduce readmissions in multiple health-systems. J Am Pharm Assoc (2003) 2019; 59:319-328. [DOI: 10.1016/j.japh.2019.01.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/30/2018] [Accepted: 01/07/2019] [Indexed: 11/18/2022]
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Lash DB, Mack A, Jolliff J, Plunkett J, Joson JL. Meds-to-Beds: The impact of a bedside medication delivery program on 30-day readmissions. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1108] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- David B. Lash
- Department of Pharmacy; Kern Medical; Bakersfield California
| | - Angela Mack
- Department of Pharmacy; Kern Medical; Bakersfield California
| | - Jeffrey Jolliff
- Department of Pharmacy; Kern Medical; Bakersfield California
| | - Joshua Plunkett
- Department of Pharmacy; Kern Medical; Bakersfield California
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16
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The developing role of community pharmacists in facilitating care transitions: A systematic review. J Am Pharm Assoc (2003) 2019; 59:265-274. [DOI: 10.1016/j.japh.2018.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 10/18/2018] [Accepted: 11/09/2018] [Indexed: 11/19/2022]
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McCarthy LM, Li S, Fernandes O, Cameron K, Lui P, Wong G, Pariser P, Farrell J, Luke MJ, Guilcher SJT. Enhanced communication between inpatient and community pharmacists to optimize medication management during transitions of care. J Am Pharm Assoc (2003) 2018; 59:79-86.e1. [PMID: 30446423 DOI: 10.1016/j.japh.2018.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/23/2018] [Accepted: 09/24/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To describe the Pharmacy Communication Partnership (PROMPT) program's approach to improving medication management for patients during transitions from hospital to the community. SETTING Two general internal medicine units within a multisite academic hospital in Canada. PRACTICE INNOVATION Designed by an interprofessional working group, PROMPT uses evidence-informed approaches to facilitate communication between pharmacists in different settings: faxing of the discharge prescription and medical discharge summary to a patient's community pharmacy, followed by a telephone call to the community pharmacist. EVALUATION A multimethod cross-sectional study used telephone surveys and retrospective chart reviews to describe: 1) the characteristics of patients that hospital pharmacists thought would benefit from PROMPT and the community pharmacies that served them; 2) the number and nature of communication attempts made by community and hospital pharmacists; and 3) community pharmacists' views about PROMPT's potential impact on continuity of care and potential program enhancements. RESULTS A convenience sample of 100 patients (median age 77 years, interquartile range 66 to 83) who received care from 86 pharmacies were used to evaluate the program. The majority of community pharmacists participating in the surveys considered the intervention to be helpful. Of the 53.7% (n = 44/82) community pharmacists who received discharge summaries, 93.2% (n = 41/44) found the summaries to be useful. Themes arising from community pharmacists' comments were categorized into 3 topics: 1) the benefits of PROMPT; 2) topics of discussion and clarification during telephone calls with hospital pharmacists; and 3) future program improvements. CONCLUSION Community pharmacists described PROMPT as a time-efficient and helpful bridge linking community pharmacy to hospital inpatient care. Opportunities for future research include determining the characteristics of patients who may benefit most from PROMPT, determining the optimal components of discharge information needed by community pharmacists to enhance medication management, and evaluating whether follow-up telephone calls from the hospital to community pharmacists are necessary for all patients.
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Wilcock M, Kelly L, Hill A. Letter to the editor: Hospitalization Drug Regimen Changes in Geriatric Patients and Adherence to Modifications by General Practioners in Primary Care. J Nutr Health Aging 2018; 22:1021. [PMID: 30272110 DOI: 10.1007/s12603-018-1040-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Wilcock
- M. Wilcock, Royal Cornwall Hospital, United Kingdom,
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