Impact of pharmacist-conducted anticoagulation patient education and telephone follow-up on transitions of care: a randomized controlled trial

Karaoui, Lamis R.; Ramia, Elsy; Mansour, Hanine; Haddad, Nisrine; Chamoun, Nibal

doi:10.1186/s12913-021-06156-2

Cited by 8 publications

(20 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Following title and abstract screening, 274 full texts were retrieved. A total of 126 RCTs involving 97 408 participants met our inclusion criteria (Figure 2). The study characteristics are presented in eAppendix 3 in Supplement 1.…”

Section: Resultsmentioning

confidence: 99%

“…Pooling data from the 73 studies (85 direct comparisons) involving 77 201 participants, low-complexity (OR, 0.78; 95% CI, 0.66 to 0.92) and medium-complexity (OR, 0.82; 95% CI, 0.68 to 0.97) interventions were associated with decreased odds of readmission at 30 days compared with usual care (Figure 3; eAppendix 2 in Supplement 1). High-intensity interventions were not associated with reductions in readmissions (OR, 0.96; 95% CI, 0.80 to 1.15).…”

Section: Resultsmentioning

confidence: 99%

“…Across 42 studies (53 direct comparisons) involving 31 988 participants, none of the 3 intervention intensities were significantly associated with reducing mortality compared with usual care (Figure 5). Global heterogeneity of the network was seen to be very low ( I 2 = 0%; 95% CI, 0% to 36%), and there was no evidence of inconsistency in the model (eAppendix 5 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

“…Pooling uptake data from 109 studies (123 direction comparisons) involving 82 623 participants, none of the intervention intensities were associated with increasing the odds of intervention uptake compared with usual care (Figure 5). Global heterogeneity of the network was seen to be moderate ( I 2 = 63%; 95% CI, 51% to 67%), and there was no evidence of inconsistency in the model (eAppendix 5 in Supplement 1) or publication bias (Egger P = .41) (eAppendix 6 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, an important but unintended finding of this review was that the range of outcomes reported by interventions was very narrow. Most trials reported hospital readmissions and, at best, some additional health care utilization outcomes (eg, ED visits, length of hospital stay), and adverse outcomes (mortality). Few trials have measured patient-reported outcomes (eg, QOL and patient satisfaction with the transitional care) and broader risks for patient harm and safety; none of the studies reported staff outcomes, despite the fact that transitional care interventions were mostly service delivery interventions relying on staff engagement for their success.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes

Tyler,

Hodkinson,

Planner

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceDischarge from the hospital to the community has been associated with serious patient risks and excess service costs.ObjectiveTo evaluate the comparative effectiveness associated with transitional care interventions with different complexity levels at improving health care utilization and patient outcomes in the transition from the hospital to the community.Data SourcesCENTRAL, Embase, MEDLINE, and PsycINFO were searched from inception until August 2022.Study SelectionRandomized clinical trials evaluating transitional care interventions from hospitals to the community were identified.Data Extraction and SynthesisAt least 2 reviewers were involved in all data screening and extraction. Random-effects network meta-analyses and meta-regressions were applied. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed.Main Outcomes and MeasuresThe primary outcomes were readmission at 30, 90, and 180 days after discharge. Secondary outcomes included emergency department visits, mortality, quality of life, patient satisfaction, medication adherence, length of stay, primary care and outpatient visits, and intervention uptake.ResultsOverall, 126 trials with 97 408 participants were included, 86 (68%) of which were of low risk of bias. Low-complexity interventions were associated with the most efficacy for reducing hospital readmissions at 30 days (odds ratio [OR], 0.78; 95% CI, 0.66 to 0.92) and 180 days (OR, 0.45; 95% CI, 0.30 to 0.66) and emergency department visits (OR, 0.68; 95% CI, 0.48 to 0.96). Medium-complexity interventions were associated with the most efficacy at reducing hospital readmissions at 90 days (OR, 0.64; 95% CI, 0.45 to 0.92), reducing adverse events (OR, 0.42; 95% CI, 0.24 to 0.75), and improving medication adherence (standardized mean difference [SMD], 0.49; 95% CI, 0.30 to 0.67) but were associated with less efficacy than low-complexity interventions for reducing readmissions at 30 and 180 days. High-complexity interventions were most effective for reducing length of hospital stay (SMD, −0.20; 95% CI, −0.38 to −0.03) and increasing patient satisfaction (SMD, 0.52; 95% CI, 0.22 to 0.82) but were least effective for reducing readmissions at all time periods. None of the interventions were associated with improved uptake, quality of life (general, mental, or physical), or primary care and outpatient visits.Conclusions and RelevanceThese findings suggest that low- and medium-complexity transitional care interventions were associated with reducing health care utilization for patients transitioning from hospitals to the community. Comprehensive and consistent outcome measures are needed to capture the patient benefits of transitional care interventions.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes

Tyler,

Hodkinson,

Planner

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

Venous Thromboembolism

Macchiavelli

2023

Medical Clinics of North America

View full text Add to dashboard Cite

Impact of pharmacist-supported transition of care services in the Middle East and North Africa: a systematic review and meta-analysis

Alhmoud,

Alrawi,

El-Enany

et al. 2024

Journal of Pharmaceutical Policy and Practice

View full text Add to dashboard Cite

Background Transition of care (TOC) is associated with an increased risk of medication-related problems. Despite recent advancements in pharmacy practice and research in the Middle East and North Africa (MENA), the characteristics and impact of regional pharmacy-supported TOC interventions remain unclear. This systematic review and meta-analysis aimed to describe pharmacist-supported TOC interventions in the MENA region and evaluate their effectiveness. Methods PubMed, CINAHL, EMBASE, Web of Science, World Health Organization’s International Clinical Trials Registry Platform (ICTRP) were searched from their inception to March 9, 2023, for experimental studies published in English, comparing pharmacist-supported TOC interventions with usual care for adults (age ≥18 years) discharged from the hospital. The risk of bias was evaluated using Cochrane’s risk-of-bias tool for randomised trials (ROB2) and the risk of bias in non-randomised studies of interventions (ROBINS-I) tool for randomised and non-randomised studies respectively. Narrative syntheses and meta-analysis methods were employed depending on the outcomes evaluated. Results Twelve studies (n = 2377 subjects), 10 randomised controlled trials and 2 quasi-experimental studies, were included. Most studies had high or serious risk of bias. The included studies were quite heterogeneous in terms of nature and the delivery of intervention, and assessment of outcome measures. Compared to the usual care group, pharmacist-led TOC interventions contributed to a significant reduction in preventable drug-related (N = 2) and cardiac-related healthcare utilisation (N = 1), a significant reduction in preventable adverse drug events (ADEs) (Odds ratio (OR) 0.34, 95% CI: 0.13-0.94) and an improvement in medication adherence. However, all-cause hospitalisation and medication discrepancies were not significantly reduced. Conclusion Pharmacy-supported TOC interventions may improve patient outcomes in the MENA region. However, considering the limited quality of evidence and the variability in intervention delivery, future well-designed clinical trials are needed.

show abstract

Impact of pharmacist-conducted anticoagulation patient education and telephone follow-up on transitions of care: a randomized controlled trial

Cited by 8 publications

References 34 publications

Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes

Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes

Venous Thromboembolism

Impact of pharmacist-supported transition of care services in the Middle East and North Africa: a systematic review and meta-analysis

Contact Info

Product

Resources

About