Export file:

Format

  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text

Content

  • Citation Only
  • Citation and Abstract

Effect of clinical pharmacist encounters in the transitional care clinic on 30-day re-admissions: A retrospective study

1 Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, N.Y. 11213, U.S.A.
2 School of Public Health, State University of New York, Downstate Medical Center, Brooklyn, N.Y., U.S.A.
3 Department of Family Medicine, State University of New York, Downstate Medical Center, Brooklyn, N.Y., U.S.A.

Hospitalized patients who meet specific criteria at discharge are referred to the transitional care clinic team consisting of a nurse practitioner and/or physician and a clinical pharmacist. In collaboration with the providers, the pharmacist reviews medications for appropriateness, assesses adherence, recommends medication changes and provides education. The purpose of this study was to measure the effect of an outpatient transitional care clinical pharmacist on 30-day re-admissions in an urban setting serving a population of low socioeconomic status. After receiving IRB approval, this single-center retrospective study analyzed records of 573 patient visits of which nearly 75% included a clinical pharmacist interaction. Rates of 30-day re-admissions were not statistically different among the two groups, however, it was found that each added co-morbidity significantly increased the patients’ 30-day re-admission rate by 26%.
  Figure/Table
  Supplementary
  Article Metrics

References

1. Kaiser Health News, Medicare To Penalize 2,217 Hospitals For Excess Re-admissions, 2016. Available from: https://khn.org/news/medicare-hospitals-readmissions-penalties/.

2. CMS.gov Centers for Medicare & Medicaid Services, Hospital Re-admissions-Reduction-Program, 2017. Available from: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program.html.

3. Miller DE, Roane TE, Mclin KD (2016) Reduction of 30-Day hospital re-admissions after patient-centric telephonic medication therapy management services. Hosp Pharm 51: 907–914.    

4. Li H, Guffey W, Honeycutt L, et al. (2016) Incorporating a pharmacist into the discharge process: A unit-based transitions of care pilot. Hosp Pharm 51: 744–751.    

5. Arnold ME, Buys L, Fullas F (2015) Impact of pharmacist intervention in conjunction with outpatient physician follow-up visits after hospital discharge on re-admission rate. Am J Health-Syst Ph 72: 36–42.

6. Ravn-Nielsen LV, Duckert ML, Lund ML, et al. (2018) Effect of In-Hospital multifaceted clinical pharmacist intervention on re-admission, JAMA Intern Med 178: 375–382.

7. Ni W, Colayco D, Hashimoto J, et al. (2018) Reduction of healthcare costs through a transitions-of-care program. Am J Health Syst Pharm 75: 613–621.    

8. Tedesco GW, Mcconaha JL, Skomo ML, et al. (2016) A pharmacist's impact on 30-Day re-admission rates when compared to the current standard of care within a patient-centered medical home. J Pharm Pract 29: 368–373.    

9. Lisenby KM, Carroll DN, Pinner NA (2015) Evaluation of a pharmacist-specific intervention on 30-Day re-admission rates for high-risk patients with pneumonia. Hosp Pharm 50: 700–709.    

10. Gasbarro NM, Eginger KH, Street C (2014) Impact of clinical pharmacist interventions on 30-Day re-admission rate in hospitalized patients with acute myocardial infarction. J Pharm Technol 31: 64–68.

11. Warden BA, Freels JP, Furuno JP, et al. (2014) Pharmacy-managed program for providing education and discharge instructions for patients with heart failure. Am J Health-Syst Ph 71: 134–139.    

12. Shull MT, Braitman LE, Stites SD, et al. (2018) Effects of a pharmacist-driven intervention program on hospital re-admissions. Am J Health-Syst Ph 75: 221–230.    

13. Mekonnen AB, Mclachlan AJ, Brien JE (2016) Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: A systematic review and meta-analysis. BMJ Open 6: e010003.    

14. Ballard J, Rankin W, Roper KL, et al. (2018) Effect of ambulatory transitional care management on 30-Day re-admission rates. Am J Med Qual 33: 583–589.    

15. Murphy JA, Schroeder MN, Rarus RE, et al. (2017) Implementation of a cardiac transitions of care pilot program: A prospective study of inpatient and outpatient clinical pharmacy services for patients with heart failure exacerbation or acute myocardial infarction. J Pharm Pract 32: 68–76.

16. Lone NI, Lee R, Salisbury L, et al. (2018) Predicting risk of unplanned hospital re-admission in survivors of critical illness: A population-level cohort study. Thorax: pii: thoraxjnl-2017-210822.

17. Mudge AM, Shakhovskoy R, Karrasch A (2013) Quality of transitions in older medical patients with frequent re-admissions: Opportunities for improvement. Eur J Intern Med 24: 779–783.    

18. Groesbeck K, Whiteman LN, Stewart RW (2015) Reducing re-admission rates by improving transitional care. South Med J 108: 758–760.    

19. Kerstenetzky L, Heimerl LM, Hartkopf KJ, et al. (2018) Inpatient pharmacists' patient referrals to a transitions-of-care pharmacist: Evaluation of an automated referral process. J Am Pharm Assoc 58: 540–546.    

20. Gil M, Mikaitis DK, Shier G, et al. (2013) Impact of a combined pharmacist and social worker program to reduce hospital re-admissions. J Manag Care Pharm 19: 558–563.

21. Phatak A, Prusi R, Ward B, et al. (2015) Impact of pharmacist involvement in the transitional care of high-risk patients through medication reconciliation, medication education, and postdischarge call-backs (IPITCH Study). J Hosp Med 111: 39–44.

22. Stranges PM, Marshall VD, Walker PC, et al. (2015) A multidisciplinary intervention for reducing re-admissions among older adults in a patient-centered medical home. Am J Manag Care 21: 106–113.

23. Kamermayer AK, Leasure AR, Anderson L (2017) The effectiveness of transitions-of-care interventions in reducing hospital Re-admissions and mortality. Dimens Crit Care Nurs 36: 311–316.    

24. Kennelty KA, Chewning B, Wise M, et al. (2015) Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives. Res Social Adm Pharm 11: 517–530.    

25. Yang S (2017) Impact of pharmacist-led medication management in care transitions. BMC Health Serv Res 17: 722.    

26. Ni W, Colayco D, Hashimoto J, et al. (2017) Impact of a pharmacy-based transitional care program on hospital readmissions. Am J Manag Care 23: 170–176.

27. Jackson C, Shahsahebi M, Wedlake T, et al. (2015) Timeliness of outpatient follow-up: An evidence-based approach for planning after hospital discharge. Ann Fam Med 13: 115–122.    

28. Hamar B, Rula EY, Wells AR, et al. (2016) Impact of a scalable care transitions program for re-admission avoidance. Am J Manag Care 22: 28–34.

29. Hansen LO, Young RS, Hinami K, et al. (2011) Interventions to reduce 30-Day rehospitalization: A systematic review. Ann Intern Med 155: 520–528.    

30. Brand CA, Jones CT, Lowe AJ, et al. (2004) A transitional care service for elderly chronic disease patients at risk of re-admission. Aust Health Rev 28: 275–284.    

31. Jones CD, Anthony A, Klein MD, et al. (2018) The effect of a pharmacist-led multidisciplinary transitions-of-care pilot for patients at high risk of re-admission. J Am Pharm Assoc 58: 554–560.    

© 2019 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Article outline

Show full outline
Copyright © AIMS Press All Rights Reserved