University of Kentucky HealthCare, Lexington, Kentucky.
Kentucky Children's Hospital - Pediatrics and University of Kentucky College of Pharmacy, Lexington, Kentucky.
Sci Diabetes Self Manag Care. 2024 Feb;50(1):32-43. doi: 10.1177/26350106231221463. Epub 2024 Jan 20.
The purpose of this study was to determine the impact of a pharmacist-managed transitions of care (TOC) clinic on outcomes in a posthospitalization population with diabetes.
A retrospective single center cohort study utilized electronic health records to identify discharged patients followed by the inpatient endocrinology team. The primary outcome was 30-day readmission rates in the target population. Secondary outcomes include 90-day readmission rates, time to first follow-up, emergency department/urgent care encounters, change in A1C, retention with endocrinology, referrals for diabetes education, and types of interventions. The control group included patients prior to the initiation of the TOC clinic compared to patients seen in the TOC clinic, evenly matched by A1C. Readmission rates and other clinical data were queried up to 4 months after discharge.
Patients in the TOC cohort had similar 30-day readmission rates compared to the non-TOC cohort and were found to have lower A1C values within 120 days of discharge. Overall, patients in the TOC cohort were more likely to have a follow-up appointment and had closer follow-up after discharge.
This study highlights that although there was no difference in readmission rates, a pharmacist-managed diabetes TOC clinic may decrease time to follow-up and improve long-term diabetes outcomes.
本研究旨在确定药剂师管理的过渡护理（TOC）门诊对出院后糖尿病患者结局的影响。
一项回顾性单中心队列研究利用电子健康记录来识别接受住院内分泌科团队随访的出院患者。主要结局是目标人群的 30 天再入院率。次要结局包括 90 天再入院率、首次随访时间、急诊/紧急护理就诊、糖化血红蛋白（A1C）变化、与内分泌科的保留率、糖尿病教育转诊以及干预类型。对照组包括 TOC 门诊启动前与 TOC 门诊就诊的患者，通过 A1C 进行均衡匹配。在出院后 4 个月内查询再入院率和其他临床数据。
与非 TOC 队列相比，TOC 队列的患者 30 天再入院率相似，但在出院后 120 天内 A1C 值较低。总体而言，TOC 队列的患者更有可能预约随访，并且在出院后随访更密切。
本研究表明，尽管再入院率没有差异，但药剂师管理的糖尿病 TOC 门诊可能会缩短随访时间并改善长期糖尿病结局。
