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Objectives: To determine if a community pharmacy-based transition of care program 1.) decreases hospital readmissions, 2.) resolves medication-related problems, and 3.) increases patient satisfaction.Methods: This prospective, quasi-experimental study compared patients who received transition of care MTM services from a community pharmacist with patients who received usual post-discharge care. Nurse case managers from two hospitals recruited and consented patients prior to discharge. Patients greater than 18 years of age and discharged home with a diagnosis of heart failure, COPD, pneumonia, or acute myocardial infarction were eligible. Case managers faxed discharge paperwork for interested patients to the selected pharmacy. MTM services occurred at community pharmacies within one week of hospital discharge. Pharmacists reconciled the patients' medications, identified drug therapy problems, recommended changes to therapy, and provided self-management education. Medication recommendations were communicated with the primary care physician and interventions were documented on a data collection form. Patients' received a two-week follow-up telephone call from the pharmacist. Research personnel conducted a 30-day telephone survey to assess hospital readmissions and patient satisfaction using a previously validated survey instrument. Preliminary Results: Sixty-five patients completed the entire study period. Six patients in the usual care group were admitted to the hospital within 30 days and nine patients were seen in the emergency room. In the 19 patients who received MTM services from the pharmacist, 126 interventions were documented and one 30-day readmission and one emergency visit was observed. The overall mean patient satisfaction with the transition of care process was not significantly different between patients who were seen by the pharmacist and those who were not. However, patients in the pharmacist only group were more likely to agree that they understand the purpose of their medications and are more confident in their ability to care for themselves at home. |
