Implementing a pharmacist-led transition of care model for posttransplant hyperglycemia

Autor:	Renata Belfort-DeAguiar, Danielle J. Haakinson, Vincent Do, Elizabeth Cohen
Rok vydání:	2021
Předmět:	Patient Transfer medicine.medical_specialty 030232 urology & nephrology Pharmacist Psychological intervention 030230 surgery Hypoglycemia Pharmacists 03 medical and health sciences Practice Research Report 0302 clinical medicine Diabetes mellitus medicine Clinical endpoint Humans Retrospective Studies Pharmacology business.industry Health Policy Retrospective cohort study Emergency department medicine.disease Exact test Hyperglycemia Emergency medicine AcademicSubjects/MED00410 business Emergency Service Hospital
Zdroj:	American Journal of Health-System Pharmacy: AJHP
ISSN:	1535-2900
Popis:	Purpose The implementation of a pharmacist-managed transition of care program for kidney transplant recipients with posttransplant hyperglycemia (PTHG) is described. Methods In September 2015, a collaborative practice agreement between pharmacists and transplant providers at an academic medical center for management of PTHG was developed. The goal of the pharmacist-run service was to reduce hospitalizations by providing care to patients in the acute phase of hyperglycemia while they transitioned back to their primary care provider or endocrinologist. For continuous quality improvement, preimplementation data were collected from August 2014 to August 2015 and compared to postimplementation data collected from August 2017 to August 2018. The primary endpoint was hospitalizations due to hyperglycemia within 90 days post transplantation. Secondary endpoints included emergency department (ED) visits due to hypoglycemia and the number of interventions performed, number of encounters completed, and number of ED visits or admissions for hypoglycemia. A Fisher’s exact test was used to compare categorical data, and a Student t test was used to compare continuous data. A P value of Results Forty-three patients in the preimplementation group were compared to 35 patients in the postimplementation group. There was a significant reduction in hospitalizations due to hyperglycemia in the postimplementation versus the preimplementation group (9 vs 1, P < 0.05); there was a reduction in ED visits due to hyperglycemia (5 vs 0, P = 0.06). There were no ED visits or hospitalizations due to hypoglycemia in either group. Clinical transplant pharmacists performed an average of 8.3 (SD, 4.4) encounters per patient per 90 days. Conclusion A collaborative practice agreement was created and successfully implemented. A pharmacist-managed PTHG program could be incorporated into the standard care of kidney transplant recipients to help minimize rehospitalizations due to hyperglycemia.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ad2ae675bea23210104fe0ef745eac36 https://pubmed.ncbi.nlm.nih.gov/33821878 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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