Impact of a pharmacy-driven transitions-of-care program on postdischarge healthcare utilization at a national comprehensive cancer center

Nguyen, Phuoc Anh Anne; Enwere, Emmanuel N.; Gautreaux, Stefani; Lin, Heather; Tverdek, Frank P.; Lu, Maggie; Cao, Henry; Chase, Judy L.; Roux, Ryan

doi:10.2146/ajhp170747

Cited by 10 publications

(18 citation statements)

References 21 publications

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“…There were nine studies that met our inclusion criteria with a total of 3496 participants (Table 1). 4,9,14,[24][25][26][27][28][29] The studies included 945 females and 1108 males, with one study of 1443 patients not reporting on the breakdown of these patients. The included studies had a weighted mean (SD) age of 60.8 (11.4).…”

Section: Included Studiesmentioning

confidence: 99%

“…In total, five studies followed a pre-and post-intervention design, 4,9,26,27,29 one study was a cohort study, 24 one study was a single arm historical cohort study 25 and two were randomised controlled trials. 14,28 All studies completed the initial pharmacist intervention face-to-face.…”

Section: Included Studiesmentioning

confidence: 99%

“…In three studies, usual care was defined as the care before pharmacist monitoring with no further elaboration. 24,26,29 Usual care in two studies included the primary specialist physician and other healthcare providers, with one also including ad hoc pharmacy consultations if requested by the patient. 25,27 A further study defined usual care as the provision of information and education by a nurse.…”

Section: Included Studiesmentioning

confidence: 99%

“…4,9,[24][25][26][27]29 Using the Newcastle-Ottawa risk of bias tool, four nonexperimental studies were assessed as good quality with the remaining assessed as fair quality. 24,25,27,29 The RCTs were assessed as high risk in two domains. 14,28 Outcomes Errors Seven studies reported medication errors which included those directly related to cancer therapies (Table 2).…”

Section: Risk Of Biasmentioning

confidence: 99%

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The impact of pharmacist‐led strategies implemented to reduce errors related to cancer therapies: a systematic review

Coutsouvelis

Siderov

Tey

et al. 2020

Pharmacy Practice and Res

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Background Patients with cancer are managed across the whole healthcare spectrum. This complex system of interdependencies has high potential for errors to occur. This is a focus area for pharmacists, who possess the skillset to optimise cancer care across the health care system, identifying errors and other medication‐related problems (MRP). Aim The aim of this study was to identify and describe the impact of the pharmacist’s contribution in reducing cancer therapy‐related errors. Methods A search of English‐language publications in Embase, Medline and CINAHL was conducted. Databases were searched from 1 January 2010 until 29 September 2020 to identify all quantitative studies of a descriptive, observational or experimental design. Articles describing pharmacist‐led interventions in adults receiving one or more cancer therapies including oral chemotherapy, intravenous chemotherapy or immunotherapy compared to no intervention, usual care or a service delivered by another healthcare professional were included. Researchers screened articles to identify eligible studies, and then data were extracted using a standardised data collection sheet. Quality assessment was undertaken using the modified Cochrane and the Newcastle Ottawa risk of bias tools. Data were reported as number or percentage. Results Of 2292 papers identified, nine studies were eligible for inclusion in this review. Pharmacist interventions consistently showed an increased identification of medication errors and medication‐related problems. Pharmacist contributions in many of the included studies comprised medication reviews and monitoring, laboratory monitoring, adverse drug reaction and drug–drug interaction management, adherence monitoring and medication counselling. All studies showed pharmacist intervention in cancer care resulted in fewer errors compared to control arms. Error minimisation was described for parenteral and oral cancer therapies and also for supportive medications such as antiemetics. Conclusion Pharmacists reduce errors and potential patient harm in practice settings where cancer patients are treated. Pharmacists are an integral component of cancer care teams.

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Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Risk Of Biasmentioning

confidence: 99%

See 2 more Smart Citations

The impact of pharmacist‐led strategies implemented to reduce errors related to cancer therapies: a systematic review

Coutsouvelis

Siderov

Tey

et al. 2020

Pharmacy Practice and Res

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show abstract

“…There is a range of transition of care models worth further evaluation in the Australian setting that integrate hospital‐delivered programs, including medication reconciliation, discharge instructions and post‐discharge telephone follow‐up, as well as mixed‐models including a post‐discharge home visit by the patient’s own community pharmacist, for example …”

Section: To Improve Transitions Of Care More Resources Should Be Allmentioning

confidence: 99%

The Case Against

Dooley

2019

Pharmacy Practice and Res

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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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Impact of a pharmacy-driven transitions-of-care program on postdischarge healthcare utilization at a national comprehensive cancer center

Abstract: While there were no significant overall differences in readmission rates between the TOC and SOC groups, hospital readmissions were reduced in the subgroup of TOC patients who received both medication history-taking and reconciliation services and phone follow-up as TOC interventions.

Cited by 10 publications

References 21 publications

The impact of pharmacist‐led strategies implemented to reduce errors related to cancer therapies: a systematic review

The impact of pharmacist‐led strategies implemented to reduce errors related to cancer therapies: a systematic review

The Case Against

Quality measures of clinical pharmacy services during transitions of care

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