Effect of a care transition intervention by pharmacists: an RCT

摘要: Pharmacists may improve medication-related outcomes during transitions of care. The aim the Iowa Continuity Care Study was to determine if a pharmacist case manager (PCM) providing faxed discharge medication care plan from tertiary institution primary could appropriateness and reduce adverse events, rehospitalization emergency department visits. Design. Randomized, controlled trial 945 participants assigned enhanced, minimal usual groups conducted 2007 2012. Subjects. Participants with cardiovascular-related conditions and/or asthma or chronic obstructive pulmonary disease were recruited University Hospital Clinics following admission general medicine, family cardiology orthopedics. Intervention. group received history, reconciliation, patient education, list recommendations inpatient team. enhanced also their community physician pharmacy telephone call 3–5 days post-discharge. followed for 90 days Main Outcomes Measures. Medication index (MAI), drug events post-discharge healthcare utilization compared by study using linear logistic regression, as models accommodating random effects due pharmacists indicated little clustering. similar at baseline intervention fidelity high. There no statistically significant differences in appropriateness, discharge, 30-day 90-day average MAI per 0.53 increased 0.75 90 days, this true across all groups. Post-discharge, about 16% experienced an event, did not differ (p > 0.05). Almost one-third had any type within 30 days post-discharge, where 15% readmission. Healthcare different 30 group. affect use perhaps because quality measures high Clinicaltrials.gov registration: NCT00513903 , August 7, 2007.