The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study.
<h4>Background</h4>Medication-related problems are common after hospitalization, for example when changes in patients' medication regimens are accompanied by insufficient patient education, poor information transfer between healthcare providers, and inadequate follow-up post-dischar...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0213593 |
| _version_ | 1819112699785641984 |
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| author | Sara Daliri Jacqueline G Hugtenburg Gerben Ter Riet Bart J F van den Bemt Bianca M Buurman Wilma J M Scholte Op Reimer Marie-Christine van Buul-Gast Fatma Karapinar-Çarkit |
| author_facet | Sara Daliri Jacqueline G Hugtenburg Gerben Ter Riet Bart J F van den Bemt Bianca M Buurman Wilma J M Scholte Op Reimer Marie-Christine van Buul-Gast Fatma Karapinar-Çarkit |
| author_sort | Sara Daliri |
| collection | DOAJ |
| description | <h4>Background</h4>Medication-related problems are common after hospitalization, for example when changes in patients' medication regimens are accompanied by insufficient patient education, poor information transfer between healthcare providers, and inadequate follow-up post-discharge. We investigated the effect of a pharmacy-led transitional care program on the occurrence of medication-related problems four weeks post-discharge.<h4>Methods</h4>A prospective multi-center before-after study was conducted in six departments in total of two hospitals and 50 community pharmacies in the Netherlands. We tested a pharmacy-led program incorporating (i) usual care (medication reconciliation at hospital admission and discharge) combined with, (ii) teach-back at hospital discharge, (iii) improved transfer of medication information to primary healthcare providers and (iv) post-discharge home visit by the patient's own community pharmacist, compared with usual care alone. The difference in medication-related problems four weeks post-discharge, measured by means of a validated telephone-interview protocol, was the primary outcome. Multiple logistic regression analysis was used, adjusting for potential confounders after multiple imputation to deal with missing data.<h4>Results</h4>We included 234 (January-April 2016) and 222 (July-November 2016) patients in the usual care and intervention group, respectively. Complete data on the primary outcome was available for 400 patients. The proportion of patients with any medication-related problem was 65.9% (211/400) in the usual care group compared to 52.4% (189/400) in the intervention group (p = 0.01). After multiple imputation, the proportion of patients with any medication-related problem remained lower in the intervention group (unadjusted odds ratio 0.57; 95% CI 0.38-0.86, adjusted odds ratio 0.50; 95% CI 0.31-0.79).<h4>Conclusions</h4>A pharmacy-led transitional care program reduced medication-related problems after discharge. Implementation research is needed to determine how best to embed these interventions in existing processes. |
| first_indexed | 2024-12-22T04:17:40Z |
| format | Article |
| id | doaj.art-bd221561426f4647916a59d5231fbe7f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T04:17:40Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-bd221561426f4647916a59d5231fbe7f2022-12-21T18:39:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01143e021359310.1371/journal.pone.0213593The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study.Sara DaliriJacqueline G HugtenburgGerben Ter RietBart J F van den BemtBianca M BuurmanWilma J M Scholte Op ReimerMarie-Christine van Buul-GastFatma Karapinar-Çarkit<h4>Background</h4>Medication-related problems are common after hospitalization, for example when changes in patients' medication regimens are accompanied by insufficient patient education, poor information transfer between healthcare providers, and inadequate follow-up post-discharge. We investigated the effect of a pharmacy-led transitional care program on the occurrence of medication-related problems four weeks post-discharge.<h4>Methods</h4>A prospective multi-center before-after study was conducted in six departments in total of two hospitals and 50 community pharmacies in the Netherlands. We tested a pharmacy-led program incorporating (i) usual care (medication reconciliation at hospital admission and discharge) combined with, (ii) teach-back at hospital discharge, (iii) improved transfer of medication information to primary healthcare providers and (iv) post-discharge home visit by the patient's own community pharmacist, compared with usual care alone. The difference in medication-related problems four weeks post-discharge, measured by means of a validated telephone-interview protocol, was the primary outcome. Multiple logistic regression analysis was used, adjusting for potential confounders after multiple imputation to deal with missing data.<h4>Results</h4>We included 234 (January-April 2016) and 222 (July-November 2016) patients in the usual care and intervention group, respectively. Complete data on the primary outcome was available for 400 patients. The proportion of patients with any medication-related problem was 65.9% (211/400) in the usual care group compared to 52.4% (189/400) in the intervention group (p = 0.01). After multiple imputation, the proportion of patients with any medication-related problem remained lower in the intervention group (unadjusted odds ratio 0.57; 95% CI 0.38-0.86, adjusted odds ratio 0.50; 95% CI 0.31-0.79).<h4>Conclusions</h4>A pharmacy-led transitional care program reduced medication-related problems after discharge. Implementation research is needed to determine how best to embed these interventions in existing processes.https://doi.org/10.1371/journal.pone.0213593 |
| spellingShingle | Sara Daliri Jacqueline G Hugtenburg Gerben Ter Riet Bart J F van den Bemt Bianca M Buurman Wilma J M Scholte Op Reimer Marie-Christine van Buul-Gast Fatma Karapinar-Çarkit The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study. PLoS ONE |
| title | The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study. |
| title_full | The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study. |
| title_fullStr | The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study. |
| title_full_unstemmed | The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study. |
| title_short | The effect of a pharmacy-led transitional care program on medication-related problems post-discharge: A before-After prospective study. |
| title_sort | effect of a pharmacy led transitional care program on medication related problems post discharge a before after prospective study |
| url | https://doi.org/10.1371/journal.pone.0213593 |
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