The effect of a pharmacist-led multidisciplinary transitions-of-care pilot for patients at high risk of readmission

Journal of the American Pharmacists Association : JAPhA
Christine D JonesRead Pierce

Abstract

To evaluate the feasibility and effect of a pharmacist-led transitions-of-care (TOC) pilot targeted to patients at high risk of readmission on process measures, hospital readmissions, and emergency department (ED) visits. Academic medical center in Colorado. Pharmacists enrolled patients identified as high risk for readmission in a TOC pilot from July 2014 to July 2015. The pilot included medication reconciliation, medication counseling, case management or social work evaluation, a postdischarge telephone call, and an expedited primary care follow-up appointment. Implementation and evaluation of the pharmacist-led TOC pilot program with risk score embedded into the electronic health record. Comparison of TOC-related process measures and clinical outcomes between pilot patients and randomly matched control patients included readmissions or ED visits at 30 and 90 days. We enrolled 34 pilot patients and randomly matched them to 34 control patients. The intervention took an average of 57.1 minutes for pharmacists to deliver. More pilot patients had a case management or social work note compared with control patients (88% vs. 59%; P = 0.006 [statistically significant]). Readmission rates in pilot versus nonpilot patients, respective...Continue Reading

Citations

Apr 20, 2021·Currents in Pharmacy Teaching & Learning·Victoria ReinhartzTayanna Richardson
Jul 11, 2021·Research in Social & Administrative Pharmacy : RSAP·Elizabeth LieuAnandi V Law
Dec 5, 2021·The Senior Care Pharmacist·Daijah DavisErika E Tillery

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