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超越目标:药剂师对家庭医疗服务中 90 天再入院率和临床结果的影响。

Aiming Beyond: A Pharmacist Impact on 90-Day Readmissions and Clinical Outcomes Within a Family Medicine Service.

机构信息

Department of Pharmacy, 21114Parkland Health & Hospital System, Dallas, TX, USA.

Department of Family and Community Medicine, 12334UT Southwestern Medical Center, Dallas, TX, USA.

出版信息

J Pharm Pract. 2020 Dec;33(6):738-744. doi: 10.1177/0897190019825970. Epub 2019 Feb 25.

Abstract

Previous studies have shown pharmacists positively impact 30-day readmission rates. However, there is limited data regarding the effect of clinical pharmacist (CP) follow-up on 90-day readmission or evaluation of disease-specific goals after hospitalization. Investigators analyzed the impact of postdischarge extended CP follow-up within a family medicine service (FMS). The primary end point was all-cause 90-day readmission rates. Secondary end points included all-cause 30- and 60-day readmission rates and the achievement of disease-specific goals postdischarge. Retrospective chart review was performed for patients admitted from August 2016 to November 2017 who were seen by a physician within the FMS 14 days postdischarge. Fourteen percent of patients within the CP intervention group were readmitted within 90 days in comparison to 22% in the standard of care group ( = .244). Readmission rates at 30 and 60 days were as follows: intervention group 2%, 10%, and standard of care group 16%, 22% ( = .015, = .089, respectively). In addition, multiple patients with uncontrolled diabetes who completed CP visits upon hospital discharge met glycemic goals at the end of the study time period. Despite inclusion of the CP in postdischarge care, 90-day readmission rate remained unchanged.

摘要

先前的研究表明,药剂师可积极影响 30 天再入院率。然而,关于临床药剂师(CP)随访对 90 天再入院或住院后评估特定疾病目标的影响的数据有限。调查人员分析了家庭医学服务(FMS)中出院后扩展 CP 随访对患者的影响。主要终点是所有原因的 90 天再入院率。次要终点包括所有原因的 30 天和 60 天再入院率以及出院后特定疾病目标的实现。对 2016 年 8 月至 2017 年 11 月期间出院后 14 天内接受 FMS 内医生就诊的患者进行回顾性图表审查。CP 干预组中有 14%的患者在 90 天内再次入院,而对照组中有 22%(=.244)。30 天和 60 天的再入院率如下:干预组为 2%、10%,对照组为 16%、22%(=.015,=.089)。此外,许多患有未控制糖尿病的患者在出院后完成 CP 就诊,在研究结束时达到了血糖目标。尽管在出院后护理中包含 CP,但 90 天再入院率保持不变。

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