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药学专业学生主导的出院后电话随访对心力衰竭患者医院再入院率的影响:一项试点项目。

Impact of Pharmacy Student-Driven Postdischarge Telephone Calls on Heart Failure Hospital Readmission Rates: A Pilot Program.

作者信息

Plakogiannis Roda, Mola Ana, Sinha Shreya, Stefanidis Abraham, Oh Hannah, Katz Stuart

机构信息

Arnold & Marie Schwartz College of Pharmacy, Brooklyn, NY, USA.

NYU Langone Health, New York City, USA.

出版信息

Hosp Pharm. 2019 Apr;54(2):100-104. doi: 10.1177/0018578718769243. Epub 2018 Apr 18.

Abstract

Heart failure (HF) hospitalization rates have remained high in the past 10 years. Numerous studies have shown significant improvement in HF readmission rates when pharmacists or pharmacy residents conduct postdischarge telephone calls. The purpose of this retrospective review of a pilot program was to evaluate the impact of pharmacy student-driven postdischarge phone calls on 30- and 90-day hospital readmission rates in patients recently discharged with HF. A retrospective manual chart review was conducted for all patients who received a telephone call from the pharmacy students. The primary endpoint compared historical readmissions, 30 and 90 days prior to hospital discharge, with 30 and 90 days post discharge readmissions. For the secondary endpoints, historical and postdischarge 30-day and 90-day readmission rates were compared for patients with a primary diagnosis of HF and for patients with a secondary diagnosis of HF. Descriptive statistics were calculated in the form of means and standard deviations for continuous variables and frequencies and percentages for categorical variables. Statistically significant decrease was observed for both the 30-day ( = .006) and 90-day ( = .007) readmission periods. Prior to the pharmacy students' phone calls, the overall group of 131 patients had historical readmission rates of 24.43% within 30 days and 38.17% within 90 days after hospital discharge. After the postdischarge phone calls, the readmission rates decreased to 11.45%, for 30 days, and 22.90%, for 90 days. Postdischarge phone calls, specifically made by pharmacy students, demonstrated a positive impact on reducing HF-associated hospital readmissions, adding to the growing body of evidence of different methods of pharmacy interventions and highlighting the clinical impact pharmacy students may have in transition of care services.

摘要

在过去十年中,心力衰竭(HF)的住院率一直居高不下。大量研究表明,当药剂师或药学住院医师在患者出院后进行电话随访时,HF再入院率有显著改善。本项对一个试点项目的回顾性研究旨在评估药学专业学生主导的出院后电话随访对近期因HF出院患者30天和90天再入院率的影响。对所有接到药学专业学生电话的患者进行了回顾性人工病历审查。主要终点是将出院前30天和90天的历史再入院率与出院后30天和90天的再入院率进行比较。对于次要终点,比较了原发性HF诊断患者和继发性HF诊断患者的历史及出院后30天和90天的再入院率。描述性统计以连续变量的均值和标准差以及分类变量的频率和百分比的形式计算。在30天(P = 0.006)和90天(P = 0.007)的再入院期均观察到有统计学意义的下降。在药学专业学生进行电话随访之前,131名患者的总体组在出院后30天内的历史再入院率为24.43%,90天内为38.17%。出院后电话随访后,30天的再入院率降至11.45%,90天降至22.90%。出院后电话随访,特别是由药学专业学生进行的随访,对降低与HF相关的医院再入院率有积极影响,这为越来越多的不同药学干预方法的证据增添了内容,并突出了药学专业学生在护理服务过渡中可能产生的临床影响。

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