Joseph Tina, Barros Rebecca A, Kim Elise, Shah Bupendra
1 Department of Pharmacy Practice, Nova Southeastern University College of Pharmacy, Fort Lauderdale, FL, USA.
2 Pharmacy Department, Flagler Hospital, St Augustine, FL, USA.
J Pharm Pract. 2018 Jun;31(3):279-283. doi: 10.1177/0897190017710525. Epub 2017 May 24.
The current literature speculates ideal postdischarge follow-up focusing on transitions from hospital to home can range anywhere between 48 hours and 2 weeks. However, there is a lack of evidence regarding the optimal timing of follow-up visit to prevent readmissions.
The purpose of this study is to evaluate the impact of early (<48 hours) versus late (48 hours-14 days) postdischarge medication reconciliation on readmissions and emergency department (ED) use.
In this retrospective study, data for patients who had a clinic visit with a primary care provider (PCP), clinical pharmacist, or both for postdischarge medication reconciliation were reviewed. Primary outcome included hospital use rate at 30 days. Secondary outcomes included hospital use rate at 90 days and hospital use rate with a postdischarge PCP follow-up visit, clinical pharmacist, or both at 30 days.
One hundred sixty patients were included in the analysis: 31 early group patients and 129 late group patients. There was no significant difference on hospital use at 30 days in patients who received early or late groups (32.3% vs 21.8%, P = .947). There was also no significant difference on hospital use at 90 days in patients in early versus late group (51.6% vs 50.3%, P = .842). The type of provider (PCP vs pharmacists) conducting postdischarge medication reconciliation did not show significance on hospital use at 30 days (19.9% vs 21.4%, P = .731).
Results from this study suggest patients can be seen up to 14 days postdischarge for medication reconciliation with no significant difference on hospital use.
当前文献推测，聚焦于从医院到家庭过渡阶段的理想出院后随访时间范围在48小时至2周之间。然而，关于随访以预防再次入院的最佳时机，缺乏相关证据。
本研究的目的是评估出院后早期（<48小时）与晚期（48小时 - 14天）进行用药核对对再次入院和急诊就诊的影响。
在这项回顾性研究中，对那些因出院后用药核对而就诊于初级保健提供者（PCP）、临床药师或两者的患者数据进行了审查。主要结局包括30天的住院使用率。次要结局包括90天的住院使用率以及出院后30天由初级保健提供者随访、临床药师或两者同时参与时的住院使用率。
160名患者纳入分析：早期组31例患者，晚期组129例患者。早期组和晚期组患者在30天的住院使用情况无显著差异（32.3%对21.8%，P = 0.947）。早期组和晚期组患者在90天的住院使用情况也无显著差异（51.6%对50.3%，P = 0.842）。进行出院后用药核对的提供者类型（初级保健提供者与药师）在30天的住院使用情况上未显示出显著差异（19.9%对21.4%，P = 0.731）。
本研究结果表明，患者出院后长达14天进行用药核对，在住院使用方面无显著差异。
