TransitionRx: Impact of community pharmacy postdischarge medication therapy management on hospital readmission rate

Luder, Heidi R.; Frede, Stacey M.; Kirby, James; Epplen, Kelly; Cavanaugh, Teresa M.; Martin-Boone, Jill E.; Conrad, Wayne F.; Kuhlmann, Diane; Heaton, Pamela C.

doi:10.1331/japha.2015.14060

Cited by 85 publications

(130 citation statements)

References 31 publications

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“…The pharmacist's role in the management of patients with COPD is primarily as an educator with regards to medication regimen and compliance, smoking cessation, and immunization. Clinical trials have documented the effectiveness of community pharmacists in performing spirometry and MTM on patient outcomes . A summary of clinical trials documenting the community pharmacist's role in the management of patients with COPD is provided in Table .…”

Section: Pharmacist's Rolementioning

confidence: 99%

“…These studies offer additional evidence that community pharmacist intervention can prevent both patient readmission and emergency room visits following discharge from the hospital . They included patients with a diagnosis of COPD, but results of the studies represent data including all patients diagnosed with the specific disease states enrolled in the studies.…”

Section: Prevention Of Exacerbation and Hospital Admissionmentioning

confidence: 99%

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A review of health‐related outcomes from community pharmacist interventions in patients with chronic obstructive pulmonary disease

Barefield

DeBellis

2019

J Am Coll Clin Pharm

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Currently, chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world and is predicted to be the third leading cause by the year 2020. The purpose of this manuscript is to review the expanding role of community pharmacists in the detection and management of patients with COPD. Pharmacists in the community setting can improve outcomes in patients with COPD by minimizing risk factors through smoking cessation interventions, prevention of disease by evaluating immunization history and early detection by providing spirometry. In addition, these pharmacists are well‐positioned for initiating medication therapy management (MTM) services, reducing noncompliance by counseling on proper medication use to ensure adherence and correct inhalation technique, as well as participating in transition of care. There is evidence that pharmacists can support other health care professionals with appropriate treatment recommendations, reducing overall direct and indirect health care costs. In summary, medications are an important tool in managing COPD, with adherence being critically important for these patients, and community pharmacists are an accessible health care professional able to perform needed medication and wellness related interventions that can improve patient outcomes.

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Section: Pharmacist's Rolementioning

confidence: 99%

Section: Prevention Of Exacerbation and Hospital Admissionmentioning

confidence: 99%

A review of health‐related outcomes from community pharmacist interventions in patients with chronic obstructive pulmonary disease

Barefield

DeBellis

2019

J Am Coll Clin Pharm

View full text Add to dashboard Cite

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“…Other studies evaluated the activities of community pharmacists during care transitions . Similar to these studies, this analysis observed community pharmacists focusing on medication reconciliation, adherence, vaccinations, disease management, and follow‐up.…”

Section: Discussionmentioning

confidence: 98%

Analysis of community pharmacist recommendations from a transitions of care study

Lussier

Graham

Tusing

et al. 2019

J Am Coll Clin Pharm

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Objective Community pharmacists are often the first healthcare professional encountered following discharge from a hospital, but what extent of services provided is not fully described across a variety of community pharmacy settings. Our objective was to capture and report recommendations made by community pharmacists during a transitions of care interventional study and to determine if visit‐related factors affected the risk of readmission. Methods The content of pharmacists' notes were analyzed from encounters during a transitions of care interventional study for patients discharged from a hospital with five high‐risk conditions (heart failure, acute myocardial infarction, diabetes, pneumonia, or chronic obstructive pulmonary disease), where the primary purpose of the intervention was to enhance inpatient and community pharmacist communication to improve patient care. Summary statistics were utilized to describe the content of pharmacist notes and actions, and a Cox proportional hazards model was used to test for the impact of several patient or visit‐related characteristics on the risk of 90‐day readmissions. Results As part of an interventional study, patients spent an average of 9 minutes (standard deviation [SD] 6.9) with pharmacists during each visit and had three visits on average within 90‐day of discharge. Responses to checklist questions were documented on 99% of notes, and pharmacists provided recommendations 58% of the time. Recommendations varied by condition with the most frequent being adherence (10%), vaccinations (8%), and disease monitoring (7%). In multivariate models, readmission was higher among patients with highest comorbidity (hazard ratio [HR] = 10.18, 95% confidence interval [CI], 3.53‐29.36), two or more medications added at discharge (HR = 3.83, 95% CI, 1.49‐9.82), or vaccine gaps (HR = 3.51, 95% CI, 1.09‐11.33). Conclusions In a transitions of care service, community pharmacists actively engaged patients and caregivers at regular intervals, providing largely patient‐oriented recommendations during relatively short consultation encounters. Patient and visit‐related items associated with higher readmission risk such as higher comorbidity, medication additions, and incomplete vaccinations signal opportunity for community pharmacist‐led interventions to improve care of patients in the postdischarge period.

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“…Though practices can vary [28], MTM services typi cally include five core elements: medication therapy review; personal medication record; medication action plan (MAP); intervention and/or referral; and docu mentation and followup [29]. MTM has been effec tive for some patient populations in reaching clinical goals, increasing compliance with recommended lab monitoring, reducing rehospitalizations and inap propriate prescribing and risk of adverse drug reac tions, and improving adherence [6,[30][31][32][33][34][35][36]. Because of its effectiveness, MTM is a service covered by insurance companies and the Medicare program in the USA [37].…”

Section: Introductionmentioning

confidence: 99%

Assessing Feasibility of Delivering Pharmacogenetic Testing in a Community Pharmacy Setting

et al. 2017

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Aim:To describe the rationale and design of a study evaluating the delivery of pharmacogenetic (PGx) testing in community pharmacies. Study rationale: Pharmacists have expressed interest in offering PGx testing; however, their lack of knowledge and experience, patients' acceptance and feasibility are unknown in this setting. Study design: Through a cluster randomized trial, we will assess pharmacist and patient experiences with delivery of PGx testing as a standalone service or integrated into medication therapy management services. Anticipated results: We anticipate that PGx testing can be delivered in a community pharmacy setting and accepted and valued by patients. Conclusion: This study is expected to provide valuable evidence about the real-world feasibility and acceptance of a community pharmacist-delivered approach of PGx testing.

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TransitionRx: Impact of community pharmacy postdischarge medication therapy management on hospital readmission rate

Cited by 85 publications

References 31 publications

A review of health‐related outcomes from community pharmacist interventions in patients with chronic obstructive pulmonary disease

A review of health‐related outcomes from community pharmacist interventions in patients with chronic obstructive pulmonary disease

Analysis of community pharmacist recommendations from a transitions of care study

Assessing Feasibility of Delivering Pharmacogenetic Testing in a Community Pharmacy Setting

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