Does the addition of a pharmacist transition coordinator improve evidence-based medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial

Crotty, Maria; Rowett, Debra; Spurling, Lisa K; Giles, Lynne C.; Phillips, Paddy A.

doi:10.1016/j.amjopharm.2005.01.001

Cited by 244 publications

(354 citation statements)

References 16 publications

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“…This type of practice setting has been demonstrated to improve the management of concomitant medications for patients [25][26][27] . Because of the severity of the toxicities that can result from many cancer treatments, cancer care providers might also be more vigilant in evaluating medication histories for css and thus more inclined to actively screen for pdis on a regular basis than during the management of non-cancer patients 28,29 .…”

Section: Discussionmentioning

confidence: 99%

Potential Drug Interactions in Patients with a History of Cancer

Chen

Cheung

2014

Current Oncology

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Background: Cancer survivors (css) are frequently exposed to polypharmacy, which might increase their risk of drug interactions. Our study aimed to determine the relative prevalence of potential drug interactions (pdis) among css compared with non-cancer respondents (ncrs). Methods: Self-reported prescription data from 4975 patients were extracted from the U.S. National Health and Nutrition Examination Survey and screened for pdis using iFacts: Drug Interaction Facts (Facts and Comparisons, St. Louis, MO, U.S.A.). The clinical significance of each pdi was graded on a 5-point scale based on the severity of the interaction and the level of evidence documenting the interaction. Summary statistics and logistic regression models were used to assess the impact of cancer history on the risk of pdis. Results: Of patients eligible for the analyses, the css (n = 302) indicated using 4.4 ± 0.22 prescriptions on average, and the ncrs (n = 908), 3.8 ± 0.09. Nearly half of both cohorts (40% of css, 43% of ncrs) had at least 1 pdi. In both cohorts, 12% were at risk for fatal or permanently debilitating effects. In multivariate analyses, css were significantly less likely than ncrs to be at risk for any pdis (odds ratio: 0.65; 95% confidence interval: 0.46 to 0.92; p = 0.02). Advanced age and low household income were associated with pdis among css. Medications most commonly prescribed to css with a pdi included metoprolol (15.6%), levothyroxine (13.6%), and furosemide (11.9%). Conclusions: Although css appear to be less susceptible than ncrs to pdis, the prevalence of pdis among css remains suboptimal. Specific subgroups of css may be particularly prone to pdis, underscoring the importance of increased vigilance.

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Section: Discussionmentioning

confidence: 99%

Potential Drug Interactions in Patients with a History of Cancer

Chen

Cheung

2014

Current Oncology

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“…[1][2][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 pharmacist to communicate effectively with patients may negatively impact a patient's ability to understand medication issues contributing to medication non-adherence. [8][9][10][11] The literature indicates patient benefits with hospital pharmacist involvement in discharge counselling and the practice has been incorporated into national pharmacy professional standards.…”

Section: Introductionmentioning

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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“…[1][2][3][4][5] Failure by a hospital pharmacist to communicate effectively with patients may negatively impact a patient's ability to understand medication issues contributing to poor health outcomes. [6][7][8][9] .…”

Section: Introduction Introduction Introduction Introductionmentioning

confidence: 99%