Transitions of Care Pharmacist Impact Following Hospitalization for Acute Myocardial Infarction.

IF 2.3 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Morgan Santalucia Augustine, Olivia Roberts, Christina Sarubbi, John Alex Toler, Nastaran Gharkholonarehe
{"title":"Transitions of Care Pharmacist Impact Following Hospitalization for Acute Myocardial Infarction.","authors":"Morgan Santalucia Augustine, Olivia Roberts, Christina Sarubbi, John Alex Toler, Nastaran Gharkholonarehe","doi":"10.1177/10600280241278791","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> Patients admitted with acute myocardial infarction (AMI) are at high risk for morbidity and rehospitalizations. Pharmacists can play a vital role in secondary prevention by providing services such as medication reconciliation and patient education upon discharge. <b>Objective:</b> The purpose of this study was to evaluate the impact of a pharmacist-led transitions of care (TOC) service on readmissions in patients hospitalized with AMI. <b>Methods:</b> This single center, pre-post observational cohort study evaluated adults with AMI who received pharmacist TOC services compared with a historical cohort who did not. Patients were excluded if they underwent cardiac surgery during admission. The primary outcome was the difference in 90-day cardiovascular (CV)-related readmissions. Secondary outcomes included 30- and 90-day all-cause readmissions, 30-day CV-related readmissions, and patients discharged on defect-free guideline-directed medical therapy (GDMT) for AMI. <b>Results:</b> There were 252 patients in each cohort included. No difference was found in 90-day CV readmissions, with a rate of 10.7% in the pre-TOC group versus 9.9% in the post-TOC group (OR 0.937, 95% CI [0.493, 1.769]; <i>P</i> = 0.842). Patients discharged on defect-free GDMT significantly increased from 61.5% pre-TOC to 87.7% post-TOC (OR 5.424, 95% CI [3.204, 9.468]; <i>P</i> < 0.001). There were no significant differences found in other key secondary outcomes. <b>Conclusion and relevance:</b> This study did not find a significant difference in hospital readmissions after implementation of a pharmacist-led TOC service. However, the service was associated with a significant increase in patients discharged on defect-free GDMT. Further studies are needed to confirm the impact of increased GDMT on clinical outcomes.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"10600280241278791"},"PeriodicalIF":2.3000,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Pharmacotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10600280241278791","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Patients admitted with acute myocardial infarction (AMI) are at high risk for morbidity and rehospitalizations. Pharmacists can play a vital role in secondary prevention by providing services such as medication reconciliation and patient education upon discharge. Objective: The purpose of this study was to evaluate the impact of a pharmacist-led transitions of care (TOC) service on readmissions in patients hospitalized with AMI. Methods: This single center, pre-post observational cohort study evaluated adults with AMI who received pharmacist TOC services compared with a historical cohort who did not. Patients were excluded if they underwent cardiac surgery during admission. The primary outcome was the difference in 90-day cardiovascular (CV)-related readmissions. Secondary outcomes included 30- and 90-day all-cause readmissions, 30-day CV-related readmissions, and patients discharged on defect-free guideline-directed medical therapy (GDMT) for AMI. Results: There were 252 patients in each cohort included. No difference was found in 90-day CV readmissions, with a rate of 10.7% in the pre-TOC group versus 9.9% in the post-TOC group (OR 0.937, 95% CI [0.493, 1.769]; P = 0.842). Patients discharged on defect-free GDMT significantly increased from 61.5% pre-TOC to 87.7% post-TOC (OR 5.424, 95% CI [3.204, 9.468]; P < 0.001). There were no significant differences found in other key secondary outcomes. Conclusion and relevance: This study did not find a significant difference in hospital readmissions after implementation of a pharmacist-led TOC service. However, the service was associated with a significant increase in patients discharged on defect-free GDMT. Further studies are needed to confirm the impact of increased GDMT on clinical outcomes.

急性心肌梗死住院后护理药剂师的过渡影响。
背景:急性心肌梗死(AMI)入院患者的发病率和再次住院的风险很高。药剂师可在出院时提供药物调节和患者教育等服务,从而在二级预防方面发挥重要作用。研究目的本研究旨在评估由药剂师主导的护理过渡(TOC)服务对急性心肌梗死住院患者再入院治疗的影响。方法:这是一项单中心、前-后观察性研究:这项单中心、前后观察队列研究评估了接受药剂师 TOC 服务的成人急性心肌梗死患者与未接受药剂师 TOC 服务的历史队列的对比情况。如果患者在入院期间接受了心脏手术,则排除在外。主要结果是 90 天心血管 (CV) 相关再入院率的差异。次要结果包括 30 天和 90 天全因再入院率、30 天心血管相关再入院率以及因急性心肌梗死接受无缺陷指导性医疗疗法 (GDMT) 出院的患者。研究结果每个队列共纳入 252 名患者。TOC前组的90天CV再入院率为10.7%,而TOC后组的90天CV再入院率为9.9%(OR为0.937,95% CI [0.493,1.769];P = 0.842)。无缺陷 GDMT 出院患者从 TOC 前的 61.5% 显著增加到 TOC 后的 87.7%(OR 5.424,95% CI [3.204,9.468];P <0.001)。其他主要次要结果无明显差异。结论及相关性:本研究未发现实施药剂师主导的 TOC 服务后再住院率有明显差异。不过,该服务与无缺陷 GDMT 出院患者的显著增加有关。还需要进一步的研究来证实增加 GDMT 对临床结果的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
5.70
自引率
0.00%
发文量
166
审稿时长
3-8 weeks
期刊介绍: Annals of Pharmacotherapy (AOP) is a peer-reviewed journal that advances pharmacotherapy throughout the world by publishing high-quality research and review articles to achieve the most desired health outcomes.The articles provide cutting-edge information about the most efficient, safe and cost-effective pharmacotherapy for the treatment and prevention of various illnesses. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 14 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信