RESUMO
Background: Transition of care (TOC) refers to the movement of patients between different health care settings due to changes in medical conditions and needs. Pharmacists can play an important role in TOC services as polypharmacy is a common reason for hospital readmission that costs the US taxpayers an average of $17 billion annually. Objective: The purpose of this study is to evaluate the impact of TOC telehealth services provided by pharmacy students at a university-based call center on 30-day hospital readmission. Methods: In this retrospective observational study, an electronic chart review was conducted for patients who were discharged from the hospital and received a telephone call from pharmacy students. Patients were referred to the pharmacy team from a primary care provider office. The co-primary endpoints were the number of 30-day all-cause hospital readmissions (including emergency department visits) and 30-day readmission due to initial admission diagnosis in patients who received a telephonic TOC call from a pharmacy student compared with patients who declined or were unable to be reached. Types of pharmacy-related TOC interventions provided by students were also collected. Results: A total of 84 patients were included in this study. All-cause 30-day readmission was similar between groups (13% vs 15.8%), whereas 30-day readmission due to initial admission diagnosis was much lower in the intervention group (5.9% vs 11.1%). Although a positive trend was observed in favor of the intervention group, a statistically significant difference was not observed for both 30-day all-cause readmission and 30-day readmission due to initial admission diagnosis. Medication reconciliation, adherence counseling, and lifestyle education (diet, exercise) are the most common topics discussed with the patients during TOC interventions. Conclusion: Using student pharmacists to provide postdischarge TOC calls can be a benefit to the patient and the health care team while offering pharmacy students valuable learning experience prior to graduation.
RESUMO
PURPOSE: To evaluate the role and impact of pharmacists in collaborative practice agreements (CPAs) in the United States. METHODS: An electronic literature review was conducted on studies addressing pharmacists' involvement in CPAs. Articles included in the review were peer-reviewed studies conducted on adults and published between 2017 and 2022. Articles investigating children were excluded. RESULTS: Of the articles identified, 8 studies met the eligibility criteria and were selected for the literature review. All of the studies were published between 2017 and 2022 in English in the United States. CPAs were already in place in 7 of the studies with variances due to different healthcare settings and patient populations. The studies evaluated the effect of pharmacist engagement in CPAs on the attainment of clinical and financial goals, satisfaction with pharmacist involvement, and existing barriers to pharmacist engagement in CPAs. Findings showed that pharmacist engagement in CPAs had a positive impact on the attainment of the desired clinical and financial goals, and providers were satisfied with pharmacist involvement. A common barrier to pharmacist involvement was the lack of reimbursement. CONCLUSION: Pharmacists engaged in CPAs have a positive impact on healthcare, and there are opportunities for expansion of pharmacists' roles in CPAs, particularly in non-traditional settings.