Christy Shannon, Sin Billy, Gim Suzanna
Brookdale University Hospital and Medical Center, Department of Pharmacy, One Brookdale Plaza, Brooklyn, NY, USA
Long Island University, Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Division of Pharmacy Practice, New York, NY, USA.
J Pharm Pract. 2016 Oct;29(5):490-4. doi: 10.1177/0897190014568674. Epub 2015 Mar 5.
To evaluate the effectiveness of an integrated Pharmacy Transitions of Care (PTC) pilot program on reducing hospital readmissions and improving patient satisfaction.
This prospective observational cohort study compares patients who participated in the PTC program to a control of usual hospital discharged patients during January through April 2014. The PTC program provided discharge medication review, medication counseling, delivery of medications to bedside, clinic scheduling, and follow-up phone calls. The primary outcome measure was 30-day readmissions. Secondary outcomes included emergency department (ED) visits, pharmacist interventions, and patient satisfaction.
Seventy patients participated in the PTC program. Compared to the control (n = 725), the study group had decreased 30-day all-cause readmissions (5.7% vs 13.8%, P = .08), 30-day readmissions for the same diagnosis (2.9% vs 8.1%, P = .18), and ED visits (18.6% vs 25%, P = .82). Twenty-five interventions during discharge medication review included discontinuation of unnecessary medications and correction of medication dose or frequency. The majority of patients were satisfied with the medication education provided (94%) and the timely delivery of prescriptions to bedside (96%).
There was no significant difference in 30-day readmission rates. However, pharmacists were able to make a positive impact on patient satisfaction and improve understanding of medications during discharge.
评估综合药学照护过渡（PTC）试点项目在降低医院再入院率和提高患者满意度方面的有效性。
这项前瞻性观察性队列研究将参与PTC项目的患者与2014年1月至4月期间常规出院的患者对照组进行比较。PTC项目提供出院用药审查、用药咨询、床边送药、门诊预约安排和随访电话。主要结局指标是30天再入院率。次要结局包括急诊就诊、药师干预和患者满意度。
70名患者参与了PTC项目。与对照组（n = 725）相比，研究组的30天全因再入院率降低（5.7%对13.8%，P = 0.08），同一诊断的30天再入院率降低（2.9%对8.1%，P = 0.18），急诊就诊率降低（18.6%对25%，P = 0.82）。出院用药审查期间进行了25次干预，包括停用不必要的药物以及纠正药物剂量或用药频率。大多数患者对提供的用药教育（94%）和处方及时送到床边（96%）感到满意。
30天再入院率没有显著差异。然而，药师能够对患者满意度产生积极影响，并在出院时提高患者对药物的理解。
