Identifying the optimal role for pharmacists in care transitions: A systematic review
| Autor: | Ensing, Hendrik T., Stuijt, Clementine C M, Van Den Bemt, Bart J F, Van Dooren, Ad A., Karapinar-Çarkit, Fatma, Koster, Ellen S., Bouvy, Marcel L., Sub Pharmacoepidemiology, UIPS - Utrecht Institute for Pharmaceutical Sciences, Pharmacoepidemiology and Clinical Pharmacology |
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| Přispěvatelé: | Sub Pharmacoepidemiology, UIPS - Utrecht Institute for Pharmaceutical Sciences, Pharmacoepidemiology and Clinical Pharmacology |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Patient Transfer
medicine.medical_specialty Alternative medicine MEDLINE Psychological intervention Pharmaceutical Science Pharmacy Pharmacists law.invention Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Patient Admission Professional Role Randomized controlled trial Nursing law Risk Factors Intervention (counseling) Health care medicine Humans Medication Errors Cooperative Behavior Physician's Role Health policy Patient Care Team Evidence-Based Medicine business.industry Health Policy Other Research Radboud Institute for Health Sciences [Radboudumc 0] Patient Discharge Benchmarking Family medicine Interdisciplinary Communication business Pharmacy Service Hospital |
| Zdroj: | Journal of Managed Care & Specialty Pharmacy, 21, 614-36 Journal of managed care & specialty pharmacy, 21(8), 614. Academy of Managed Care Pharmacy (AMCP) Journal of Managed Care & Specialty Pharmacy, 21, 8, pp. 614-36 |
| ISSN: | 2376-0540 |
| Popis: | Item does not contain fulltext BACKGROUND: A transition from one health care setting to another increases the risk of medication errors. Several strategies have been applied to improve care transitions and reduce adverse clinical outcomes. Pharmacist intervention during and after hospitalization has been frequently studied and show a variable effect on these outcomes. OBJECTIVE: To identify the components of pharmacist intervention that improve clinical outcomes during care transitions. METHODS: MEDLINE, EMBASE, International Pharmaceutical Abstracts, and Web of Science databases were searched for randomized controlled trials (RCTs) that studied pharmacist intervention with regard to hospitalization. Two reviewers independently screened all references published from inception to November 2014, extracted data, and assessed risk of bias. RESULTS: A total of 30 studies met the inclusion criteria. A model was created to categorize and cluster components of pharmacist intervention. The average number of components deployed, stages of hospitalization covered, and intervention targets were equally distributed between effective and ineffective studies. A best evidence synthesis of 15 studies revealed strong evidence for a clinical medication review in multifaceted programs (5 effective vs. 0 ineffective studies). Conflicting evidence was found for an isolated postdischarge intervention, admission medication reconciliation, combining postdischarge interventions with in-hospital interventions, and covering of multiple stages. Closely collaborating with other health care providers enhanced the effectiveness. CONCLUSIONS: Although there is a need for well-designed and well-reported RCTs, the study heterogeneity enabled a best evidence synthesis to elucidate effective components of pharmacist intervention. In isolated postdischarge intervention programs, evidence tends towards collaborating with nurses and tailoring to individual patient needs. In multifaceted intervention programs, performing medication reconciliation alone is insufficient in reducing postdischarge clinical outcomes and should be combined with active patient counseling and a clinical medication review. Furthermore, close collaboration between pharmacists and physicians is beneficial. Finally, it is important to secure continuity of care by integrating pharmacists in these multifaceted programs across health care settings. Ultimately, pharmacists need to know patient clinical background and previous hospital experience. |
| Databáze: | OpenAIRE |
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