Impact analysis of virtual ambulatory transplant pharmacists during COVID‐19

Abstract

Introduction During the coronavirus disease 2019 (COVID‐19) pandemic, transplant centers were challenged to meet the demand for new telemedicine strategies. The ability of lung transplant providers (LTP) to conduct face‐to‐face clinic visits for high‐risk immunocompromised patients, such as lung transplant recipients (LTR), was limited. Through the implementation of comprehensive medication management visits, pharmacists were able to assist LTP in the transition to telemedicine. Methods A retrospective chart review of telephone encounters from cardiothoracic (CT) transplant pharmacists at our center from March to September 2020 was completed. LTR scheduled for clinic visits with LTP were called prior to the visit by CT transplant pharmacists who conducted medication list reviews, adherence assessments, and medication access assistance. Clinical recommendations were communicated directly to the LTP and documented in patient electronic medical records. The primary outcome was the number of pharmacist‐driven clinical interventions. Secondary endpoints included the clinical severity and value of service of each intervention, percentage of accepted recommendations, patient cost savings interventions, prevention of adverse events, and avoidance of inappropriate doses. Results From March to September 2020, the CT transplant pharmacists conducted 385 virtual visits on 157 LTR with a median of 20 minutes spent per visit. There were 891 total interventions made by CT transplant pharmacists, including 778 medication discrepancies identified. Over 60% of encounters demonstrated some form of medication error and over 55% of encounters exhibited value of pharmacy services. Conclusion Implementation of CT transplant pharmacist telehealth visits has potential for increased patient access to pharmacy care and improved accuracy of medication lists. When focusing on the severity of errors and value of services, most demonstrated a level of significance. Further investigation is needed to analyze the impact of this service on patient outcomes as well as cost‐effectiveness.

Telephone versus In-Person Pharmacist-Led Medication Reviews in Home Dialysis Patients: Evaluating Quality of Care and Patient Satisfaction

“…Patients reported a similar quality of care with telephone medication reviews and found them to be convenient and effective. This study supports existing literature that pharmacists have a positive impact on clinical outcomes and maintain clinical services with telephone-based care, with evidence from individual studies and systematic reviews indicating this positive impact existing across clinical care disciplines and in both outpatient and inpatient settings [ 6 , 7 , 8 , 9 , 10 , 15 , 16 ].…”

Systematic literature review of adopting eHealth in pharmaceutical care during COVID-19 pandemic: recommendations for strengthening pharmacy services

“…After removing duplicates (n=795), and screening by the title and abstract (n=230) and full text (n=121), 43 articles were included in this review 20–62. Among the included studies were 25 observational studies (including 13 cross-sectional studies,36–39 43–48 54 59 60 5 case series,34 35 49–51 5 retrospective study,40 41 52 53 55 1 prospective study61 and 1 interview study42 and 18 descriptive studies 20–33 56–58 62. The general characteristics of the included studies are summarised in online supplemental table 1.…”

“…The general characteristics of the included studies are summarised in online supplemental table 1. The majority of the studies reported about the use of eHealth by hospital pharmacists,20 21 23 25 29–31 33–35 37–41 43 46–49 52–55 58 59 61 followed by community pharmacists 28 35 45 46 50 51 54 60 62. Patients with chronic diseases27 31 32 34 37 39 40 43 44 48 52 54 57 60–62 were the primary targets populations of PC-eHealth interventions, followed by patients with COVID-1926 34 42 46 49–51 58 and patients with cancer 27 31 37 40…”

“…The purpose of adopting eHealth, the eHealth tools used, the interventions provided by pharmacists with eHealth and the intervention output are illustrated in online supplemental table 2. Considering the lack of official definition or categorisation framework of eHealth applied to PC, the purposes of adopting eHealth in this study were informed by the current literature8 63–65 and thus categorised into: (1) tele-education (educating patients about how to take medicines and adverse drug effects, n=17)20 22 24 25 29 31–33 37–39 42 47 48 56 57 62; (2) tele-consultation (addressing patients’ enquiries about drug-related problems, n=28)20 21 23 25–28 30–33 35–38 44 45 49–51 53 56–62; (3) tele-monitoring (monitor the patients’ use of medications in real time, n=27)20 21 23 25–27 29–33 35 36 38 39 41 44–46 48–51 53–55 57; (4) tele-case-management (continuously manage the patient’s medication regimen according to the patient’s conditions, n=30)22 23 26 27 29 30 32–34 37–42 44 46 48–54 56–61 and (5) tele-mentoring (the use of eHealth by other healthcare workers to seek advice from pharmacists, n=19) 21 25 28 30 31 33 34 38–40 42–44 47 48 53 57 59 62. It is noteworthy that all but five studies22 24 46 52 56 reported the use of eHealth for multiple purposes.…”

Challenges and opportunities of clinical pharmacists during COVID-19: A review of the literature

“…Most of the services included providing patient counseling and monitoring medication adherence. A study from a transplant clinic evaluated the services provided by ambulatory transplant pharmacists during the pandemic (Park et al, 2021). Within a seven-month period, 385 virtual clinic visits were conducted with lung transplant recipients with more than 890 interventions made, most of which were related to medications errors and involved patient education.…”