Standardizing a transitions of care pharmacist workflow for tobacco cessation efforts.

ABSTRACT

OBJECTIVE: This project aimed to describe a standardized transitions of care (TOC) pharmacist workflow for tobacco cessation efforts for patients at hospital discharge and to secondarily evaluate patient participation, impact on cessation outcomes, and pharmacist effort necessary to provide the service. PRACTICE DESCRIPTION TOC pharmacists provide medication optimization and education to patients admitted to and discharged from Norton Healthcare hospitals. Medication optimization for tobacco cessation occurs through a recommendation to a provider or by initiating the dispensing of pharmacotherapy through the Kentucky Board of Pharmacy authorized protocol. PRACTICE INNOVATION A standardized workflow was created for TOC pharmacists to identify patients who use tobacco, assess patients' current tobacco use and willingness to quit, select appropriate pharmacotherapy, document, and follow-up with these patients post-discharge. EVALUATION METHODS: A retrospective descriptive study was performed for adult patients assessed by TOC pharmacists for tobacco cessation between November 2021 and April 2022, with follow up visits completed through December 2022. RESULTS: During this pilot project, 357 patients were assessed and 252 (70.6%) stated they were interested in tobacco cessation. Of those interested, 117 (46.4%) patients indicated they were interested in participating and receiving follow-up from the TOC pharmacists and refills from a Norton Pharmacy. Of the 117 patients interested in follow-up, 73 (62.4%) patients completed at least one follow-up visit with the TOC pharmacist. At the last completed follow-up visit, 26 (35.6%) patients reported complete tobacco cessation. Of the 47 patients that did not have complete cessation, they reported using 39% less tobacco on average when compared to their initial assessment at hospital discharge. The mean time spent by the TOC pharmacist utilizing this workflow was 13.5 minutes per follow-up visit. CONCLUSIONS: This project formalized a standardized and sustainable TOC pharmacist workflow that demonstrated a positive impact on tobacco cessation efforts for participating patients.