Evaluation of a Pharmacy-Driven Inpatient Discharge Counseling Service: Impact on 30-Day Readmission Rates

Still, Kimberly L.; Davis, Azizza K.; Chilipko, Allison A.; Jenkosol, Aroonjit; Norwood, Daryn K.

doi:10.4140/tcp.n.2013.775

Cited by 23 publications

(34 citation statements)

References 8 publications

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“…The beneficial effects of patient discharge counselling on patient outcomes include decreased adverse drug events and 30 day readmission rates. 4,66,67 Amy, relayed an incident of helping a patient understand the rationale for their medication and the patient's appreciation of this knowledge.…”

Section: Improving Patients' Experiences Health and Safetymentioning

confidence: 99%

Hospital pharmacists' perceptions of medication counseling: A focus group study

Chevalier

Watson

Barras

et al. 2016

Research in Social and Administrative Pharmacy

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BackgroundMedication counselling sessions are key times for a pharmacist to speak to patients about their medications and the changes made to their therapies during their hospital stay. ObjectivesTo explore hospital pharmacists' perceptions of their roles and goals in patient medication counselling, and perceived barriers and facilitators to achieving their goals. MethodsHospital pharmacist focus groups were held in two tertiary referral hospitals. Eligible pharmacists had provided medication counselling within the previous six months in inpatient and/or outpatient settings. Interested pharmacists attended a focus group designed to elicit their opinions and perceptions of patient medication counselling. Focus groups were audio recorded and transcribed verbatim. Inductive thematic analysis was applied to the data to identify initial patterns (codes) which were then organized into common overarching themes using NVivo ® software. The codes were reviewed for reliability by pharmacists independent of the focus groups. ResultsSix, one-hour focus groups were conducted with a total of 24 pharmacists participating. Saturation of information was determined after four focus groups. Greater than 80% consensus was achieved for reliability of the identified codes. A number of themes emerged from these codes around the goals, roles, and the barriers and facilitators to meeting these goals. Pharmacists' patient-centred goals in medication counselling were to build rapport, to empower patients and to improve patients' experience, health and safety. These goals would be accomplished through specific roles such as being an assessor, educator and problem-solver. Pharmacists frequently cited time pressures caused by systemic (hospital), and pharmacy specific processes as key challenges to achieving their goals. Factors that enabled pharmacists to meet their goals were those related to effective interprofessional collaboration and the quality of professional practice (such as training, expanded roles and advanced planning for discharge). ConclusionsHospital pharmacists emphasised patient-centred goals in medication counselling and outlined the challenges to meet those goals. The findings from this study will be used to develop strategies for effective communication and inform pharmacy practice changes to improve patient care. Key Words Hospital pharmacist Focus group Goal Role Communication M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPTPage 2 of 27 IntroductionDischarge from hospital to community or to other healthcare facilities marks an important transition in care for patients. Discharge and other transitions such as admission to hospital or transfers within a hospital have been identified as particular times when patients may be at risk of experiencing medication errors and adverse events. 1-3 Medication counselling opportunities are key times for pharmacists to speak to patients about their medications and the changes made to their therapies during their hospital stay. 2,[4][5][6][7] Failure by a hospital phar...

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Section: Improving Patients' Experiences Health and Safetymentioning

confidence: 99%

Hospital pharmacists' perceptions of medication counseling: A focus group study

Chevalier

Watson

Barras

et al. 2016

Research in Social and Administrative Pharmacy

View full text Add to dashboard Cite

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“…Given these parameters, patient participation in the PPMDP did not reduce hospital 30-day readmission rate. Previous studies have shown varying reports of pharmacist intervention and reducing readmission rates; [5][6][7] however, these studies did not look at pediatric patients. Rate of readmission in this study was higher at 12.7% compared to a previously reported rate of 6.5% for pediatric patients.…”

Section: Discussionmentioning

confidence: 94%

“…5 Pharmacistdriven discharge counseling was associated with decreased 30-day readmission rates for adult internal medication moderate-risk patients and averaged 4 pharmacy interventions per patient. 6 Extrapolating these results to pediatric patients, the investigators hypothesized that participation in the program led to increased medication adherence and understanding of medications, and therefore decreased rates of readmission.…”

Section: Introductionmentioning

confidence: 99%

Effect of a Pediatric Prescription Medication Discharge Program on Reducing Hospital Readmission Rates

Leathers¹,

Brittain²,

Crowley³

2017

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVESTo evaluate the pediatric prescription medication discharge delivery and counseling program, implemented at an 186-bed children's hospital integrated within a larger academic medical center, and its effectiveness on reducing hospital readmissions.METHODS This study was a retrospective chart review of existing data in the electronic medical record from patients <21 years of age who were discharged from our institution between September 1, 2014, and November 30, 2014. Patients who participated in the pediatric discharge program were compared to non-participants. The primary objective was to determine if the patient was readmitted within 30 days. Secondary objectives included time until readmission, diagnosis at discharge, and hospital unit at discharge. RESULTSIn total, 1804 patients were assessed. After exclusions, 932 subjects were included in the analysis. In total, 393 (42.2%) patients participated in the pediatric medication discharge and counseling program, and 539 did not participate. Of the patients who participated in the program, 52 were readmitted within 30 days (13.2%), compared with 67 patients (12.4%) who did not participate in the discharge program, p = 0.717. Patients with the diagnoses of malignancy and kidney injury were more likely to be readmitted within this time frame, and those with the diagnoses of heart defects or cardiology disorders and malignancy were more likely to participate in the pediatric prescription medication discharge program.CONCLUSION Participation in the pediatric discharge medication delivery and counseling program did not reduce hospital readmission rate within 30 days.ABBREVIATIONS EMR, electronic medical record; PCICU, pediatric cardiac intensive care unit; PPMDP, pediatric prescription medication discharge program; RSV, respiratory syncytial virus

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“…It combined the bedside face‐to‐face counselling and the use of a leaflet, which have been demonstrated to be effective in improving the patients’ knowledge about medications if used concurrently . The counselling intervention enables a two‐way communication between pharmacists and patients, while the leaflet helps the patients to recall the instructions given by pharmacists after discharge from hospitals …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a hospital-based education programme in improving knowledge of the use of nonsteroidal anti-inflammatory drugs among heart failure patients in a Malaysia regional hospital

Choong

Lew

George

et al. 2018

Journal of Pharmaceutical Health Services Research

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Objectives The use of nonsteroidal anti‐inflammatory drugs (NSAIDs) in heart failure patients is known to be associated with a wide range of adverse events, including an increased risk of cardiovascular complications. This study aimed to evaluate the effectiveness of an education programme in improving the knowledge about the safety of NSAID use among the hospitalized heart failure patients. Method This was a single‐arm, quasi‐experimental study. It was undertaken in a regional referral centre in Perak State, Malaysia. Each recruited patient received an educational leaflet and a 10‐min counselling intervention by a clinical pharmacist. A 5‐item questionnaire was used to assess their knowledge before and after the intervention. Each correct answer was awarded with 1 point, and a patient with a total score of 3 points or above was considered having adequate knowledge. Key findings A total of 31 patients received the intervention and completed the assessment. They were mainly female (61%), with a median age of 68 (interquartile range (IQR) = 22) years. Of all the patients, four (13.3%) reported a long‐term use of NSAIDs, while only one (3.2%) reported the use of NSAIDs in 1 week before the hospitalization. The postintervention score (median = 3; IQR = 2) was shown to be significantly higher than the preintervention score (median = 1; IQR = 2; P = < 0.001). Additionally, the majority of the patients (86.7%) found the education programme was useful to avoid unnecessary NSAID use in the future. Conclusions Our findings suggest that the pharmacist‐initiated education programme is useful and could be used as a long‐term strategy to improve the knowledge about the safety of NSAID use in heart failure patients.

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Evaluation of a Pharmacy-Driven Inpatient Discharge Counseling Service: Impact on 30-Day Readmission Rates

Abstract: Pharmacy discharge counseling was associated with reduced 30-day readmission rates in those patients at moderate risk for readmission.

Cited by 23 publications

References 8 publications

Hospital pharmacists' perceptions of medication counseling: A focus group study

Hospital pharmacists' perceptions of medication counseling: A focus group study

Effect of a Pediatric Prescription Medication Discharge Program on Reducing Hospital Readmission Rates

Effectiveness of a hospital-based education programme in improving knowledge of the use of nonsteroidal anti-inflammatory drugs among heart failure patients in a Malaysia regional hospital

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