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COVID-19 has necessitated alterations to the delivery of healthcare services. Modifications include those made to improve patient and healthcare worker safety such as the use of personal protective equipment. Pharmacy services, specifically pharmacy transitions of care services have not been immune to change which have brought along their own set of unique challenges to consider. This paper discusses how COVID-19 has impacted the delivery of pharmacy transitions of care services with real world examples from Sharp Grossmont Hospital and Hoag Memorial Hospital Presbyterian. Procedures implemented to minimize the spread and contraction of COVID-19 such as minimized patient contact and altered visitor policies have made it more challenging to obtain a best possible medication list the patient was taking prior to arrival to the hospital which has lead to an increased reliance on secondary sources to complete medication histories. Regarding discharge prescriptions, preference has shifted to the use of electronic vs. hard copy prescriptions, mail order, and utilization of med to bed programs and other hospital medication delivery services to limit patient contact in outpatient pharmacies. An improved effort to resolve medication acquisition issues prior to discharge utilizing patient assistance programs and other hospital programs to cover the cost of medications for COVID positive patients under certain circumstances has been seen. This paper highlights the important role pharmacists can play in providing effective communication, supporting continuity of care, and advocating for patient engagement and empowerment during transitions of care in the COVID-19 pandemic.

Background Effective communication between pharmacists across healthcare settings is essential to facilitate transitions of care (TOC) and improve patient outcomes. Objective To explore pharmacists’ communication methods and preferences and identify barriers to communication during TOC. Methods A survey was distributed to a convenience sample of pharmacists in California, Connecticut, Illinois, Massachusetts, New Jersey, and Texas. The survey collected information on pharmacists’ demographics, practice settings, and clinical services, and their methods, preferences, and barriers to communication during TOC. Results A total of 308 responses were included in the analysis. The majority of pharmacists practiced in inpatient pharmacy (39.3%) followed by outpatient community pharmacy (23.4%). About 57.8% of pharmacists reported involvement in TOC services. Among respondents, most reported electronic health record (EHR) as their primary method of communication to receive (66.2%) and send (55.5%) information to perform TOC services. Additionally, EHR was reported as the preferred method of communication to receive (75.4%) and send (75.5%) information during TOC. The primary reasons pharmacists reported not utilizing patient health information were lack of information (38.4%), incorrect information (36.7%), delay in receiving information (36.7%), and lack of time (34.5%). Barriers to providing TOC services included poor communication during handoffs (44.2%) and difficulty obtaining needed patient medical information (43.9%). Conclusion This study identified methods and barriers to communication between pharmacists during TOC across healthcare settings. This provides an opportunity for future research to develop interventions to improve communication between pharmacists at different practice settings.

Objective To provide an up-to-date review of the available evidence regarding pharmacotherapeutic management of venous thromboembolic events in the geriatric population. Data Sources A PubMed search of articles published through August 2017 was performed using a combination of the following words: apixaban, betrixaban, dabigatran, edoxaban, enoxaparin, geriatric, heparin, idaricizumab, rivaroxaban, and venous thromboembolism. Study Selection/data Extraction Relevant original research, review articles, and guidelines were assessed for the management of elderly patients with venous thromboembolism (VTE). References from the above literature were also evaluated. Articles were selected for inclusion based on relevance to the topic, detailed methods, and complete results. Data Synthesis VTE, which includes deep vein thrombosis and pulmonary embolism, is common in the geriatric population. Elderly patients are at high risk for VTE, but management is complicated by comorbidities and a higher risk of bleeding. Until recently, warfarin has been the mainstay of therapy. Newer oral anticoagulants, which include apixaban, dabigatran, edoxaban, and rivaroxaban are now available, but there is limited information on their safety and efficacy in the geriatric population. This article reviews the current literature regarding outcomes and summarizes pharmacotherapeutic management of VTE in the elderly population. Conclusion Appropriate management of pharmacotherapy for VTE can help improve outcomes in elderly patients, and pharmacists can provide guidance and education regarding evidence-based therapy.