Implementation of an emergency department–based clinical pharmacist transitions-of-care program

Abstract

A TOC pharmacist-led program targeting patients who arrived at the ED with the chief complaint of asthma exacerbation, COPD, or CHF provided interventions from an ED or ambulatory care pharmacist as well as follow-up opportunities at outpatient clinics or an HBMM program.

Medication Therapy Management for Texas MediCAID Patients With Asthma and Chronic Obstructive Pulmonary Disease—A Pilot Study

“…Pharmacist-provided interventions for asthma and COPD patients typically include drug regimen management, education to patients or caregivers of children with asthma, and behavior modification. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Such intervention programs could be focused on a single issue approach (e.g., inhaler technique only), or could follow a comprehensive model that involves complex patient care, such as medication therapy management (MTM). A landmark example of an MTM intervention is The Asheville Project, a U.S. study which included an education and MTM program for patients with asthma.…”

Essential Role of Pharmacists in Asthma Care and Management

“…In an inpatient setting, patients seeking care at emergency departments for an exacerbation of asthma, COPD, or congestive heart failure were assessed for their medication adherence or administration technique, patient-specific concerns with respect to medication use, the need for modification of therapy, access to medications at discharge, contraindicated medications, and vaccinations, if applicable, and subsequently referred by pharmacists to follow-up in either an ambulatory care pharmacy clinic or with the home-based medication management program. 94 Although a small exploratory study, it highlighted the potential role of pharmacists in transition-of-care programs at discharge and follow-up opportunities at outpatient clinics or home-based medication management programs. In another study, pharmacists’ intervention in the discharge process increased the proportion of patients discharged in possession of their medications and decreased unplanned visits after discharge in a cohort of 102 children with asthma.…”

Implementation of an Advanced Pharmacy Practice Model in the Emergency Department

“…Although research is listed as an urgent need in the ASHP EMP guidelines, none of the literature we identified described the incorporation of a structured research program as part of an EM pharmacy practice model. 4 -6,7 -10,15 -17,20 -24,30,44,45 The creation of a research program by a pharmacotherapist elevated pharmacists as a leading health-care professional in research. It also provided a platform for pharmacists and physicians to collaborate and consistently produce peer-reviewed publications aimed to advance the scientific literature and patient care.…”

“…To the best of our knowledge, despite the availability of the literature which described ED pharmacy services, few described the implementation of an advanced practice model based on recommendations provided by the 2011 PPMI Consensus. 3 -24 Furthermore, no update has been made to the 2011 American Society of Health-System Pharmacist (ASHP) guidelines on EM pharmacist (EMP) services. 29…”