The impact of community pharmacist involvement on transitions of care: A systematic review and meta-analysis

Lussier, Mia E.; Evans, Haley J.; Wright, Eric A.; Gionfriddo, Michael R.

doi:10.1016/j.japh.2019.07.002

Cited by 21 publications

(23 citation statements)

References 63 publications

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“…What remains essential is that institutions continue to provide transitions of care services, as the value of pharmacist interventions in reducing readmissions and supporting patient safety has been clearly demonstrated. 39 , 40 , 41 , 42 , 43 , 44 This may require adapting workflow and resources to ensure pharmacists are able to provide transitions of care services through phone and telehealth encounters, including collecting patient information, reconciling medications, providing patient education, addressing adherence barriers, and supporting continuity of care.…”

Section: Effective Communication: Providing Patient Education/intervimentioning

confidence: 99%

The impact of COVID-19 on pharmacy transitions of care services

Herzik

Bethishou

2021

Research in Social and Administrative Pharmacy

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COVID-19 has necessitated alterations to the delivery of healthcare services. Modifications include those made to improve patient and healthcare worker safety such as the use of personal protective equipment. Pharmacy services, specifically pharmacy transitions of care services have not been immune to change which have brought along their own set of unique challenges to consider. This paper discusses how COVID-19 has impacted the delivery of pharmacy transitions of care services with real world examples from Sharp Grossmont Hospital and Hoag Memorial Hospital Presbyterian. Procedures implemented to minimize the spread and contraction of COVID-19 such as minimized patient contact and altered visitor policies have made it more challenging to obtain a best possible medication list the patient was taking prior to arrival to the hospital which has lead to an increased reliance on secondary sources to complete medication histories. Regarding discharge prescriptions, preference has shifted to the use of electronic vs. hard copy prescriptions, mail order, and utilization of med to bed programs and other hospital medication delivery services to limit patient contact in outpatient pharmacies. An improved effort to resolve medication acquisition issues prior to discharge utilizing patient assistance programs and other hospital programs to cover the cost of medications for COVID positive patients under certain circumstances has been seen. This paper highlights the important role pharmacists can play in providing effective communication, supporting continuity of care, and advocating for patient engagement and empowerment during transitions of care in the COVID-19 pandemic.

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Section: Effective Communication: Providing Patient Education/intervimentioning

confidence: 99%

The impact of COVID-19 on pharmacy transitions of care services

Herzik

Bethishou

2021

Research in Social and Administrative Pharmacy

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“…4 The benefits of pharmacist involvement during care transitions are well known. 5,6 However, the optimal role for pharmacists as part of the transitional care team has not been well established. Ensing and colleagues conducted a large systematic review highlighting the significant degree of heterogeneity in pharmacist interventions during care transitions.…”

Section: Introductionmentioning

confidence: 99%

“…The benefits of pharmacist involvement during care transitions are well known 5,6 . However, the optimal role for pharmacists as part of the transitional care team has not been well established.…”

Section: Introductionmentioning

confidence: 99%

A new spin on transitions of care: Pharmacists bridging the gap between inpatient and outpatient settings

Leistman¹,

Nagel

Ahmed-Sarwar

2020

J Am Coll Clin Pharm

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Introduction: Benefits of pharmacist involvement during transitions of care (TOC) are well validated in the literature, but this role remains highly variable and institution specific. The purpose of this study is to describe the impact on acute health care utilization and overall patient outcomes when a pharmacist is added to a unique TOC team that encompasses both ambulatory and acute care settings. Methods: This study is a retrospective review of an established TOC service that recently added a pharmacist. As part of this service, patients meeting prespecified criteria received pharmacist intervention during inpatient rounds and discharge follow-up visit(s). The primary outcome was the change in number of acute health care encounters (emergency department [ED] visits and/or hospital readmissions). Secondary outcomes included type, frequency, and duration of patients' health care encounters, reason(s) for readmissions/ED visits, clinical pharmacist interventions, and changes in disease state-specific outcomes. Patients served as their own control and results were compared between the 6 months prior to and after initial pharmacist intervention. Results: In total, 44 patients were included. In the 6 months following initial pharmacist intervention, total number of acute health care encounters decreased by 39.5% (P < .001). Among patients readmitted or seen in the ED after initial pharmacist intervention, 28.3% occurred within 30 days of hospital discharge. Acute health care utilization was considered preventable in seven (29.2%) hospital readmissions and three (13.6%) ED visits. Average time between admissions increased by 6.6 days (P = .020). Provider-pharmacist discharge co-visits were completed for 75% of patients and a total of 182 pharmacist interventions were performed. Median time to first discharge follow-up visit was six days (interquartile range, 4-8). Conclusion: Incorporating a pharmacist into an established TOC team, working across both the inpatient and outpatient settings, resulted in a significant decrease in number of acute health care encounters per patient and increased time out of the hospital.

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“…A growing number of health systems have developed internal specialty pharmacies to alleviate barriers to accessing specialty medications, improve appropriate utilization and optimization of specialty agents, and streamline transitions in care [13][14][15][16][17]. Several studies have demonstrated the benefit of pharmacists in maintaining continuity of care for patients transitioning from one healthcare setting to another [18,19]. However, little work has explored distinctive transitions in care faced by patients on specialty treatments or assessed how pharmacist involvement could ease these transitions.…”

Section: Introductionmentioning

confidence: 99%

An Integrated Health-System Specialty Pharmacy Model for Coordinating Transitions of Care: Specialty Medication Challenges and Specialty Pharmacist Opportunities

et al. 2019

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Adherence and persistence to specialty medications are necessary to achieve successful outcomes of costly therapies. The increasing use of specialty medications has exposed several unique barriers to certain specialty treatments’ continuation. Integrated specialty pharmacy teams facilitate transitions in sites of care, between different provider types, among prescribed specialty medications, and during financial coverage changes. We review obstacles encountered within these types of transitions and the role of the specialty pharmacist in overcoming these obstacles. Case examples for each type of specialty transition provide insight into the unique complexities faced by patients, and shed light on pharmacists’ vital role in patient care. This insightful and real-world experience is needed to facilitate best practices in specialty care, particularly in the growing number of health-system specialty pharmacies.

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The impact of community pharmacist involvement on transitions of care: A systematic review and meta-analysis

Cited by 21 publications

References 63 publications

The impact of COVID-19 on pharmacy transitions of care services

The impact of COVID-19 on pharmacy transitions of care services

A new spin on transitions of care: Pharmacists bridging the gap between inpatient and outpatient settings

An Integrated Health-System Specialty Pharmacy Model for Coordinating Transitions of Care: Specialty Medication Challenges and Specialty Pharmacist Opportunities

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