Effect of Postdismissal Pharmacist Visits for Patients Using High-Risk Medications

Herges, Joseph R.; Herges, Lori B.; Dierkhising, Ross A.; Mara, Kristin C.; Davis, Amanda Z.; Angstman, Kurt B.

doi:10.1016/j.mayocpiqo.2017.12.004

Cited by 17 publications

(27 citation statements)

References 12 publications

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“…This was also true at 60 and 180 days after the visit. While previous research indicates that PCC visits in this population may reduce the risk of hospital readmission overall, the timeliness of the visit may not be critically important. This result should not encourage less timely visits after hospital discharge, but could reduce the sense of urgency for scheduling.…”

Section: Discussionmentioning

confidence: 78%

“…Patients included in the study had polypharmacy and were receiving at least one medication linked to increased rates of emergency hospitalization due to adverse effects. Patients who received a PCC visit instead of usual care had a significantly lower readmission risk at 30, 60, and 180 days . The timing of PCC visits in that study varied from 1 to 30 days.…”

Section: Introductionmentioning

confidence: 81%

“…In our previous study, we compared the risk of 30‐day hospital readmission among adult patients who were seen for a PCC visit after hospital discharge compared to usual care . These patients were on at least 10 total medications and one high‐risk medication.…”

Section: Methodsmentioning

confidence: 99%

“…Patients who received a PCC visit instead of usual care had a significantly lower readmission risk at 30, 60, and 180 days. 16 The timing of PCC visits in that study varied from 1 to 30 days.…”

Section: Anothermentioning

confidence: 99%

“…In our previous study, we compared the risk of 30-day hospital readmission among adult patients who were seen for a PCC visit after hospital discharge compared to usual care. 16 These patients were on at least 10 total medications and one high-risk medication. Medication classes considered high risk were loop diuretics, noninsulin hypoglycemic agents, oral anticoagulants, low-molecular-weight heparins, and antiplatelet agents (excluding aspirin less than 325 mg daily).…”

Section: Design Setting and Participantsmentioning

confidence: 99%

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Timing of pharmacist‐clinician collaborative visits after hospital discharge and their effect on readmission risk

Herges

Dierkhising

et al. 2019

J Am Coll Clin Pharm

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Objectives The primary objective of this study was to determine whether pharmacist‐clinician collaborative (PCC) visits within 7 days after hospital discharge (early‐visit cohort) would reduce the risk of 30‐day hospital readmission compared with PCC visits eight or more days after hospital discharge (late‐visit cohort). Methods This retrospective study of adult primary care patients was conducted from July 26, 2013 to April 1, 2016. Patients who were included were receiving at least one medication that put them at high risk for emergent hospital admission and at least 10 total medications. A Cox proportional hazards model was used to assess 30‐day readmission risk between the two groups. Results The early‐visit cohort included 393 patients; the late‐visit cohort included 109 patients. After adjusting for statistically different baseline characteristics and the LACE index score (which predicts the risk of death or unplanned readmission within 30 days after hospital discharge), 30‐day readmission risk was not significantly different between the late‐visit cohort and the early‐visit cohort (hazard ratio, 0.8; 95% confidence interval [CI], 0.34‐1.88; P = 0.61). Similarly, the difference was not significant 60 and 180 days after the PCC visit. Conclusion Patients in the early‐visit cohort had no greater risk of readmission 30 days after the visit than patients in the late‐visit cohort. Although previous research indicates that PCC visits may have significant benefits for decreasing readmission risk, delaying them may not increase the patient's risk. This finding may allow more flexibility in scheduling a pharmacist and a primary care clinician to meet with the patient.

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Anothermentioning

confidence: 99%

Section: Design Setting and Participantsmentioning

confidence: 99%

See 3 more Smart Citations

Timing of pharmacist‐clinician collaborative visits after hospital discharge and their effect on readmission risk

Herges

Dierkhising

et al. 2019

J Am Coll Clin Pharm

Self Cite

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Facilitating the transfer of care from secondary to primary care: a scoping review to understand the role of pharmacists in general practice

Yahya¹,

Nazar

Huckerby³

et al. 2023

Int J Clin Pharm

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Background Limited published research exists on the role of pharmacists in general practice (primary care pharmacists) in facilitating post-hospital discharge care of patients. Aim To summarise and map the nature and extent of current evidence on the role of primary care pharmacists in facilitating patient discharge from secondary to primary care and to inform future practice and research. Method Six electronic databases were systematically searched from inception to March 2022 for studies published in the English language that described and/or evaluated primary care pharmacist-led interventions for patients following hospital discharge. Grey literature and reference lists of included studies were also searched. Two authors independently screened articles for selection. A structured, pilot-tested form was used for data extraction. Results Twenty articles were included. The majority of studies (n = 17; 85%) were conducted in the USA. The most frequently reported intervention made by primary care pharmacists were medication reviews (n = 18) and medication reconciliation (n = 16). Studies have demonstrated the emerging roles of pharmacists involving collaboration with other healthcare professionals, review of laboratory monitoring, referrals, and follow-up. A wide range of outcomes such as the impact on hospital readmission rates, healthcare utilisation and reduction of potential adverse drug events were reported. Conclusion Pharmacists in general practice can offer a range of interventions in facilitating transfer of care of patients from secondary to primary care with positive patient and healthcare utilisation outcomes. However, more rigorous research evidence is required to establish the effectiveness, generalisability, acceptability, and sustainability of these services.

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Pharmacist-led transitions-of-care services in primary care settings: Opportunities, experiences, and challenges

Slazak¹,

Cardinal²,

Will³

et al. 2020

Journal of the American Pharmacists Association

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Effect of Postdismissal Pharmacist Visits for Patients Using High-Risk Medications

Cited by 17 publications

References 12 publications

Timing of pharmacist‐clinician collaborative visits after hospital discharge and their effect on readmission risk

Timing of pharmacist‐clinician collaborative visits after hospital discharge and their effect on readmission risk

Facilitating the transfer of care from secondary to primary care: a scoping review to understand the role of pharmacists in general practice

Pharmacist-led transitions-of-care services in primary care settings: Opportunities, experiences, and challenges

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