Tedesco Gary W, McConaha Jamie L, Skomo Monica L, Higginbotham Suzanne K
Mylan School of Pharmacy, Duquesne University, Pittsburgh, PA, USA
Mylan School of Pharmacy, Duquesne University, Pittsburgh, PA, USA.
J Pharm Pract. 2016 Aug;29(4):368-73. doi: 10.1177/0897190014568671. Epub 2015 Jan 28.
To evaluate the effect transition of care follow-up and counseling performed by a pharmacist, within a physician's practice, can have on 30-day hospital readmissions among Medicare patients when compared to the current standard of care
A pharmacist telephonically contacted patients ≥65 years with Medicare insurance following hospital discharge to perform medication reconciliation, review discharge instructions, and schedule a follow-up appointment (n = 34). At this follow-up appointment, the pharmacist reviewed the patient's electronic medical record (EMR) and communicated recommendations to the physician. The current standard of care, which does not involve a pharmacist, at a similar local physician practice was used as a comparative group (n = 45) RESULTS: The difference in 30-day readmission rates did not reach statistical significance (P = .27); however, there was a trending decrease in the percentage of patients readmitted between the control and the intervention groups (26.7% vs 14.7%). Additionally, there was nearly a statistically significant decrease in readmission rates for those patients who interacted with the pharmacist face to face versus only telephonically (P = .05) CONCLUSIONS: These results impact the decision to continue and expand the pilot program and demonstrate that pharmacists in the ambulatory setting based within a patient-centered medical home have a potential role in decreasing 30-day hospital readmissions.
评估在医生诊所内，药剂师进行的护理随访和咨询服务的转变，与当前护理标准相比，对医疗保险患者30天内再次入院率的影响。
药剂师在患者出院后通过电话联系年龄≥65岁且有医疗保险的患者，进行用药核对、复查出院指导并安排随访预约（n = 34）。在这次随访预约中，药剂师查看患者的电子病历（EMR）并向医生传达建议。将类似当地医生诊所中不涉及药剂师的当前护理标准作为对照组（n = 45）。结果：30天再入院率的差异未达到统计学显著性（P = 0.27）；然而，对照组和干预组之间再次入院患者的百分比呈下降趋势（26.7%对14.7%）。此外，与药剂师面对面交流的患者与仅通过电话交流的患者相比，再入院率几乎有统计学显著性下降（P = 0.05）。结论：这些结果影响了继续和扩大试点项目的决策，并表明以患者为中心的医疗家庭环境中的门诊药剂师在降低30天内再次入院率方面具有潜在作用。
