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A35level of satisfaction than those who paid. Higher levels of satisfaction were also reported among illiterates, older adults and those with no job compared to those with higher education, merchants and government employees. ConClusions: This study showed that the overall mean satisfaction level of clients of the outpatient pharmacy was low and it differed among different socio-demographic characteristics. Further research in to the reasons behind the low satisfaction should be done to provide appropriate solutions to improve the service.

Scientific Reports 6: Article number: 30828; published online: 26 August 2016; updated: 02 May 2017 In the original version of this Article, the author list for the “TEDDY Study Group” was incomplete. This has now been corrected in the PDF and HTML versions of this Article.

Background: The initial management of acute aortic dissection centers around rapid control of blood pressure and heart rate, commonly requiring initiation of continuous intravenous (IV) antihypertensive agents and intensive care unit (ICU) admission. However, there is limited guidance for when and how to transition off IV infusions to enteral agents, potentially extending ICU length of stay (LOS) in stable patients who are otherwise ready for floor transfer. The objective of this study is to compare the impact of rapid vs. slow transition from IV to enteral vasoactive medications on ICU LOS. Methods:In this retrospective cohort study of 56 adult patients admitted with aortic dissection requiring IV vasoactive infusions for >6 hours, patients were grouped by time required to fully transition from IV to enteral vasoactive agents. Patients who transitioned in ≤72 hours were considered the "rapid" group, and the "slow" group required >72 hours to fully convert. The primary endpoint was ICU LOS.Results: For the primary endpoint, the median ICU LOS was 3.6 days for the "rapid" group, compared to 7.7 days in the "slow" group (P<0.001). The "slow" group required a significantly longer duration of IV vasoactive infusions (115.7 vs. 36.0 hours, P<0.001) and also trended towards longer median hospital LOS.The two cohorts had similar incidences of hypotension.Conclusions: In this study, rapid transition to enteral antihypertensives within 72 hours was associated with a shorter ICU LOS without an increase in hypotension.

We read with great enthusiasm the recent article published in your journal entitled, "Implementation of a Cardiac Transitions of Care Pilot Program: A Prospective Study of Inpatient and Outpatient Clinical Pharmacy Services for Patients with Heart Failure (HF) Exacerbation or Acute Myocardial Infarction (AMI)." 1 Murphy et al's article details results of their pharmacist-lead, multidisciplinary Transitions of Care (TOC) Program tailored to cardiac patients. 1 Specifically, the authors compared 30-day readmission rates 2 for HF and AMI patients after implementation of their TOC Program relative to historical data as their primary outcome. 1-3 They considered 72-hour emergency department (ED) visit rates, 30-day mortality, and compliance with follow-up medication therapy management (MTM) appointments as secondary outcomes. The study period ran approximately 2 years from 2013 through 2015 at a single facility in the Midwest and was comprised of 193 (100 HF and 93 AMI) patients. Unfortunately, the authors found no significant improvement in 30-day readmission rates, 72-hour ED visit rates, or 30-day mortality rates for either the HF or AMI group in unadjusted comparisons. Rates for 30-day readmission and 72-hour ED visits were actually equal or trended higher for both patient cohorts, while rates for follow-up MTM appointments appeared too low for meaningful comparisons. The authors did not report attempts to adjust for patient mix pre-(historical) or post-(study) TOC program, although no evidence was given to suggest that patient mix had changed from historical to study time period. The authors' reasoning for lack of "positive findings" included possibility of clinicians diverting more challenging or sicker HF patients into the TOC program, the relative small sample of patients in the TOC program, limited amount of patients' time, and possible patient geographical barriers. Despite the lack of evidence, the authors remained upbeat toward the potential of pharmacist-led TOC programs for HF and AMI patients to improve 30-day readmission rates and other outcomes. We wish to provide encouragement by briefly highlighting findings from our pharmacist-led TOC program, resulting from collaboration between pharmacy academia and a community hospital. It