药剂师与急诊到家庭的过渡护理。

Pharmacists and transitions of care from emergency department to home.

机构信息

School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, The State University of New York, 3435 Main St, 344 Abbott Hall, Buffalo, NY 14214. Email:

出版信息

Am J Manag Care. 2023 Dec;29(12):715-719. doi: 10.37765/ajmc.2023.89473.

DOI:10.37765/ajmc.2023.89473

PMID:38170487

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10926005/

Abstract

OBJECTIVES

To determine the impact of a pharmacist-led telephone outreach program among patients discharged from the emergency department (ED) to home.

STUDY DESIGN

We conducted a randomized controlled study from February to November 2019 at a tertiary care academic medical center.

METHODS

At ED discharge, participants were randomly assigned to usual care (controls) or usual care plus the pharmacist's review (intervention group). Eligible individuals included those being discharged from the ED to home with 8 or more medications. A pharmacist telephoned patients in the intervention group within 48 to 96 hours after ED discharge. The medications in the patient's record from the ED were compared with what the patient was taking at home. Discrepancies were communicated to the primary provider via fax or telephone. The primary outcome was overall health care utilization including unplanned hospital readmissions or ED visits within 30 days of discharge. The effect of the intervention on the number of acute events was analyzed using a Poisson regression model adjusting for relevant baseline characteristics.

RESULTS

Of 90 eligible participants, 45 patients each were in the intervention and control groups. A total of 26 patients (58%) in the intervention group were reached, and 56 interventions were provided by the pharmacists. There was no significant difference between groups for overall health care utilization (adjusted risk ratio [aRR], 1.01; 95% CI, 0.50-2.06; P = .96), hospitalizations (aRR, 0.20; 95% CI, 0.02-2.18; P = .19), and ED visits (aRR, 1.24; 95% CI, 0.56-2.79; P = .59).

CONCLUSIONS

A pharmacist-led telephone outreach program conducted after ED discharge was not associated with a change in health care utilization.

摘要

目的

确定药剂师主导的电话随访计划对从急诊科（ED）出院回家的患者的影响。

研究设计

我们在 2019 年 2 月至 11 月在一家三级保健学术医疗中心进行了一项随机对照研究。

方法

在 ED 出院时，参与者被随机分配到常规护理（对照组）或常规护理加药剂师审查（干预组）。符合条件的个体包括从 ED 出院回家、服用 8 种或更多药物的患者。在 ED 出院后 48 至 96 小时内，干预组的患者由药剂师通过电话联系。将患者 ED 记录中的药物与患者在家中服用的药物进行比较。通过传真或电话将差异传达给初级提供者。主要结局是出院后 30 天内的整体医疗保健利用情况，包括非计划性住院再入院或 ED 就诊。使用泊松回归模型调整相关基线特征分析干预对急性事件数量的影响。

结果

在 90 名符合条件的参与者中，每组有 45 名患者进入干预组和对照组。共有 26 名（58%）干预组患者被联系，药剂师共提供了 56 次干预。两组整体医疗保健利用情况（调整后的风险比[aRR]，1.01；95%CI，0.50-2.06；P=0.96）、住院（aRR，0.20；95%CI，0.02-2.18；P=0.19）和 ED 就诊（aRR，1.24；95%CI，0.56-2.79；P=0.59）均无显著差异。