Evaluation of Clinical Pharmacist Services in a Transitions of Care Program Provided to Patients at Highest Risk for Readmission.
Evaluation of Clinical Pharmacist Services in a Transitions of Care Program Provided to Patients at Highest Risk for Readmission.
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DOI：
10.1177/0897190018806400
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发表时间：
2020-06
影响因子：
1.3
通讯作者：
中科院分区：
文献类型：
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作者：
实施了门诊过渡护理计划，包括药剂师提供的全面药物审查（CMR）。目标是：(1) 比较接受药剂师 CMR 的患者与未安排的合格患者之间 30 天的再入院率，(2) 描述已发现的问题和建议，以及 (3) 量化建议接受率。 2016 年 3 月至 10 月期间进行了一项回顾性队列研究。纳入标准为：LACE 评分≥13、已建立密歇根医学初级保健、并从特定住院服务机构出院回家。主要结局是 30 天的再入院率。对药剂师发现的问题、建议和建议接受率进行了检查。使用χ2分析和描述性统计。 355 例出院符合纳入标准，药剂师为 159 名患者提供了 CMR。平均年龄为 60 岁（标准差 [SD]：14.3），大多数为女性 (54%) 和白人/白种人 (69%)。接受 CMR 的患者 30 天再入院率没有显着差异 (p = .96)。每次访问平均发现 3.1 个问题（SD：1.8，范围：1-10）。提供了 509 条建议，大约 50% 被提供商接受。未观察到再入院率降低；然而，药剂师在从医院到家的过渡过程中确定了对高危患者进行干预的许多领域。
An ambulatory transition of care program, including a pharmacist-provided comprehensive medication review (CMR), was implemented. The objectives were to: (1) compare 30-day hospital readmission rates between those who received the pharmacist CMR versus eligible patients not scheduled, (2) describe identified problems and recommendations, and (3) quantify recommendation acceptance rates. A retrospective cohort study was conducted between March and October 2016. Inclusion criteria were: LACE score of ≥13, established Michigan Medicine primary care, and discharged from specific inpatient services to home. The primary outcome was 30-day hospital readmission rates. Pharmacist-identified problems, recommendations, and recommendation acceptance rates were examined. χ2 analysis and descriptive statistics were used. 355 discharges met inclusion criteria and pharmacists provided CMRs for 159 patients. The average age was 60 years (standard deviation [SD]: 14.3), the majority were female (54%), and white/Caucasian (69%). There was no significant difference in 30-day readmission rates in patients who received a CMR (p = .96). A mean of 3.1 problems were identified per visit (SD: 1.8, range: 1–10). 509 recommendations were provided and approximately 50% were provider accepted. Reduced readmission rates were not observed; however, pharmacists identified many areas for intervention in highest risk patients during the transition from hospital to home.
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影响因子：
5.7
作者：
Forster, AJ;Murff, HJ;Bates, DW
通讯作者：
Bates, DW
影响因子：
2.6
作者：
Phatak, Arti;Prusi, Rachael;Postelnick, Michael
通讯作者：
Postelnick, Michael
影响因子：
3.6
作者：
Hawes, Emily M.;Maxwell, Whitney D.;Lin, Feng-Chang
通讯作者：
Lin, Feng-Chang
影响因子：
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作者：
Walker, Paul C.;Bernstein, Steven J.;Flanders, Scott A.
通讯作者：
Flanders, Scott A.
影响因子：
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作者：
Schnipper, JL;Kirwin, JL;Bates, DW
通讯作者：
Bates, DW