Impact of Pharmacist‐led Discharge Counseling on Hospital Readmission and Emergency Department Visits: A Systematic Review and Meta‐analysis

Bonetti, Aline F.; Reis, Wálleri Christini Torelli; Mendes, António M.; Rotta, Inajara; Tonin, Fernanda S.; Fernández-Llimós, Fernando; Pontarolo, Roberto

doi:10.12788/jhm.3182

Cited by 16 publications

(16 citation statements)

References 60 publications

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“…The impact of pharmacist-led discharge counseling on hospital readmission and emergency department visit has been well studied in different patient populations and clinical conditions [ 23 – 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, pharmacist education and post-discharge follow-up on anticoagulation therapy significantly increased patient communication with their providers within 3 days postdischarge. The impact of pharmacist-led discharge counseling on hospital readmission and emergency department visit has been well studied in different patient populations and clinical conditions [23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

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

Karaoui

Ramia

Mansour

et al. 2021

BMC Health Serv Res

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Background There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates. Methods This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge. Results Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups. Conclusions Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge. Trial registration Lebanon Clinical Trial Registry LBCTR2020033424. Retrospectively registered. Date of registration: 06/03/2020.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Karaoui

Ramia

Mansour

et al. 2021

BMC Health Serv Res

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“…Ongoing gaps include, but are not limited to, variability in outcome definitions, data collection processes, measurement of outcome effects from single vs comprehensive or sequential interventions, and isolation of direct effects of specific pharmacy services together with or without other non‐pharmacy services. Overall, despite heterogeneities in patient populations, services, processes, and interventions, many examples of common HCU metrics have been represented 65‐70 …”

Section: Quality Measures and Associated Metricsmentioning

confidence: 99%

Quality measures of clinical pharmacy services during transitions of care

King

Burkhardt

Rafferty

et al. 2021

J Am Coll Clin Pharm

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The impact of clinical pharmacy transitions of care (TOC) services on relevant quality measures (QMs) has been a major focus in the recent biomedical literature. The 2020 ACCP Transitions of Care Task Force was charged with updating a 2012 white paper that focused on process indicators of quality clinical pharmacy services during TOC. The Task Force extensively reviewed the recent literature and regulatory measures relevant to TOC services. Given the wide heterogeneity and apparent uncertainty in these measures, the Task Force identified a need to define broader groupings for QMs so that pharmacy TOC services could more be reliably compared across various institutions and practice settings. The Task Force recommends QMs for the processes used to identify, and ultimately resolve, medication discrepancies (QM‐1) and medication therapy problems (MTPs) (QM‐2). Although interventions through various processes can be used to resolve medication discrepancies and MTPs, the findings of these interventions are closely aligned with the major outcomes from these TOC services. Therefore, the Task Force strongly recommends that the successful resolution of medication discrepancies and MTPs be studied for their potential roles as intermediate, or surrogate, QMs (iQM‐1, iQM‐2, respectively) because these are most likely to directly influence or predict quality related to major outcomes from TOC services. In addition, three QMs related to major outcomes are recommended, which are consistent with the triple aim: QM‐3: Health Care Utilization (HCU), QM‐4: Satisfaction and Engagement, and QM‐5: Economics. QM‐3, QM‐4, and QM‐5 span patient‐centered outcomes to institutional, or clinician‐based, outcomes. Specific metrics used for each QM are recommended. In addition to highlighting confounding variables affecting findings in the recent literature, broader contextual considerations that may support TOC services or span multiple practice settings are summarized. Future studies must adopt standard QMs and seek to understand the potential of iQMs to accurately predict success within major patient‐centered and institutional outcomes.

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“…Pharmacists can help with medication-related problems in different settings. 13,[57][58][59] Polypharmacy and inappropriate medications: the pharmacist can check the appropriateness of medications to make recommendations for clinicians; Non-adherence: the pharmacist can check the patient's medication adherence or discrepancy, provide counselling, identify the patient's difficulties, and communicate with clinicians to modify the medication regimen. Pharmacists provide both in-patient and out-patient service, the latter in the form of pharmacist-led drug compliance clinics, and their services further extend to the community through public-private partnerships.…”

Section: Pharmacistmentioning

confidence: 99%

Medication-related problems in older people: how to optimise medication management

Wong

2020

Hong Kong Med J

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Older patients are at risk of medication-related problems because of age-related physiological changes and multiple medications taken for multiple co-morbidities. The resultant polypharmacy is frequently associated with inappropriate medication use, which in turn contributes to a range of adverse consequences, including geriatric syndromes (eg, falls, cognitive decline, urinary incontinence) and hospitalisation. In addition, medication nonadherence or discrepancies between the medications prescribed and those actually taken by patients, either intentional or unintentional, are prevalent and can lead to treatment failure. A large proportion of adverse drug events are preventable, and medication errors occur most commonly at the stages of prescribing and subsequent monitoring. There are a number of strategies to address these issues with the aim of ensuring safe prescribing. Furthermore,

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Impact of Pharmacist‐led Discharge Counseling on Hospital Readmission and Emergency Department Visits: A Systematic Review and Meta‐analysis

Cited by 16 publications

References 60 publications

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

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

Quality measures of clinical pharmacy services during transitions of care

Medication-related problems in older people: how to optimise medication management

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