Development and implementation of a postdischarge home-based medication management service

Pherson, Emily; Shermock, Kenneth M.; Efird, Leigh; Gilmore, Vi; Nesbit, Todd; LeBlanc, Yvonne; Brotman, Daniel J.; Deutschendorf, Amy; Swarthout, Meghan

doi:10.2146/ajhp130764

Cited by 28 publications

(26 citation statements)

References 5 publications

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“…This target sample size was estimated as sufficient to assess feasibility, as previous pharmacist-physician collaborative studies and pharmacist-led PGx studies have demonstrated implementation feasibility with similar sample sizes. 23,[27][28][29][30][31][32] In March 2016, the research pharmacist began reviewing charts of the practice sites' electronic health records to determine potentially eligible patients, and in April 2016, enrollment commenced. When the research pharmacist was on site, she collaborated with staff to introduce the consent process to potentially eligible patients and to ascertain whether these patients were experiencing any MRPs around the time of the scheduled PCP appointment.…”

Section: Patient Enrollmentmentioning

confidence: 99%

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care

et al. 2017

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Purpose: The purpose of this study was to implement a clinical pharmacist-led medication therapy management (MTM) service within a primary-care setting that is enhanced by 1) a clinical decision support system (CDSS) that includes a unique combination of medication risk mitigation factors, which aids the pharmacist in interpreting the medication profile, and 2) pharmacogenomics (PGx) testing.Methods: This was a service implementation study, whereby Medicare beneficiaries were eligible if they were patients of Elmwood Family Physicians, a private family, primary care practice with 2 locations in New Jersey, and were on at least 7 medications. Patients had a medication reconciliation completed by a pharmacist and performed a PGx buccal swab. Patient information was run through a CDSS to aid the pharmacist with screening for multidrug interactions and assessing patient's medication-related risks. The output of the CDSS was used to create recommendations and provide a consult to the physicians. Recommendations were followed up by return of the consult. Primary care physicians (PCPs) are the most frequent prescribers of medications, with over 65% to 75% of medications being prescribed in the primarycare setting. 1,2 Although medications are a critical intervention for the prevention and treatment of medical conditions, they also can be associated with medication-related problems (MRPs). A MRP is This article was externally peer reviewed.

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Section: Patient Enrollmentmentioning

confidence: 99%

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care

et al. 2017

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“…Almost all clinic‐based TOC models include at least one of the following provided by the pharmacist: CMM, medication education, or self‐efficacy counseling. Interventions reduce readmissions, resolve medication‐related problems, and increase the patient's self‐reported medication knowledge and adherence …”

Section: Best Practicesmentioning

confidence: 99%

“…Almost all clinic-based TOC models include at least one of the following provided by the pharmacist: CMM, medication education, or self-efficacy counseling. Interventions reduce readmissions, resolve medication-related problems, and increase the patient's self-reported medication knowledge and adherence 43,45,56. Ideally, the post-discharge follow-up should be planned and scheduled at the time of hospital discharge to ensure that a plan is in place before the patient leaves the hospital.…”

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confidence: 99%

Role of clinical pharmacists and pharmacy support personnel in transitions of care

Stranges

Jackevicius

Anderson

et al. 2020

J Am Coll Clin Pharm

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Patients moving between health care settings or providers are at increased risk of complications, including unplanned hospital readmissions and medication errors. Several actions must occur in concert with members of the health care team and across settings to ensure coordinated and continuous care for patients undergoing these transitions of care (TOC). Clinical pharmacists support patients during care transitions by providing interventions and services designed to improve medication outcomes. Clinical pharmacists and team members who support clinical pharmacist activities (eg, pharmacy students, technicians, and residents) are located throughout the care continuum, from acute care to care in the community, with each contributing to improved TOC outcomes. This article provides information on evidence of high‐impact clinical pharmacist TOC practices to serve as a practical guide for practitioners interested in starting or improving TOC activities. This article also addresses current and emerging best practices and offers suggestions for improving clinical pharmacist involvement in care transition activities.

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“…These benefits of the pharmacist being available onsite for consultation builds on work of others that pharmacist home visits and collaboration with nurses are beneficial. [6][7][8] Limitations of this survey primarily relate to the small sample size. The survey was purposely limited to one agency because of the unique consultant pharmacist model at the site.…”

Section: Reasons For Referralmentioning

confidence: 99%

“…2 Recent publications report on pharmacist reviews in home care patients both for reducing fall risk and assessing for medicationrelated problems as well as pharmacist home visits, both in and outside of HHC agencies. [3][4][5][6][7] Pharmacist home visits in HHC patients have been shown to decrease hospitalization and emergency visits. 8 However, there still exists a paucity of data on the perceived and/or actual value of a consultant pharmacists in the HHC setting.…”

Section: Introductionmentioning

confidence: 99%

Assessed Value of Consultant Pharmacist Services in a Home Health Care Agency

Clark

Gates²,

McKeirnan³

et al. 2016

Consult Pharm

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Clinicians indicated consultant pharmacist services are beneficial and they used the consultant pharmacist primarily for pain management, drug side effects, and drug interactions, but made referrals for a wide range of reasons. This indicates that an onsite consultant pharmacist is valuable to home care providers. Further research regarding the benefit of an onsite consultant pharmacist in the home care setting is warranted.

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Development and implementation of a postdischarge home-based medication management service

Cited by 28 publications

References 5 publications

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care

Role of clinical pharmacists and pharmacy support personnel in transitions of care

Assessed Value of Consultant Pharmacist Services in a Home Health Care Agency

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