Keshia R De Guzman, Nazanin Falconer, Neil Cottrell, Ian D Coombes, Holly Foot, Pei Wen Koh, Shelley Wilkinson, Kelvin Robertson, Chariclia Paradissis, William Y S Wang, Jared A Miles, John James Atherton, Centaine L Snoswell, Vivian Bryce, Sue Carson, Andrew R Jones, Michael A Barras
{"title":"Pharmacist-led transition of care services in patients with cardiovascular disease: a systematic scoping review.","authors":"Keshia R De Guzman, Nazanin Falconer, Neil Cottrell, Ian D Coombes, Holly Foot, Pei Wen Koh, Shelley Wilkinson, Kelvin Robertson, Chariclia Paradissis, William Y S Wang, Jared A Miles, John James Atherton, Centaine L Snoswell, Vivian Bryce, Sue Carson, Andrew R Jones, Michael A Barras","doi":"10.1159/000547172","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Transition of care (ToC) is a critical time that requires effective management, especially for patients with cardiovascular disease, who have complex health needs. Pharmacists can play an integral role in improving medication safety and care coordination at ToC. This review determined the types of pharmacist-led multidisciplinary ToC services and associated outcomes in patients with cardiovascular disease.</p><p><strong>Methods: </strong>A systematic literature search of four databases; PubMed, Embase, CINAHL, and Scopus, was undertaken from inception until June 2023. Abstracts and full text were screened against eligibility criteria. Extracted data included study characteristics, ToC service descriptions, primary and secondary outcomes, limitations, and key findings. Study findings were synthesised narratively. The types of in-patient and post-discharge activities and their effect on patient outcomes were critiqued and presented.</p><p><strong>Results: </strong>Of the 1822 studies identified, 37 were included in the final review. The most common primary outcome reported was 30-day all cause readmissions (n=14). Pharmacist-led ToC services incorporated a diverse combination of inpatient and post-discharge activities. The most common in-patient activities included medication history and reconciliation, patient medication education, and medication review and optimisation. The most common post-discharge activities were medication review and optimisation, adherence assessments, and medication education. Multifaceted ToC services that involved inpatient and post-discharge activities demonstrated statistically significant changes in readmission rates and other patient reported outcomes.</p><p><strong>Conclusion: </strong>A variety of multifaced approaches to pharmacist-led ToC services have been evaluated within many studies, reporting favourable effects on outcomes for patients with cardiovascular disease. Tailoring ToC services to specific patient populations and settings, targeting activities to high-risk patients, and a multidisciplinary approach, are important to optimise ToC and patient outcomes.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-42"},"PeriodicalIF":1.9000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000547172","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Transition of care (ToC) is a critical time that requires effective management, especially for patients with cardiovascular disease, who have complex health needs. Pharmacists can play an integral role in improving medication safety and care coordination at ToC. This review determined the types of pharmacist-led multidisciplinary ToC services and associated outcomes in patients with cardiovascular disease.
Methods: A systematic literature search of four databases; PubMed, Embase, CINAHL, and Scopus, was undertaken from inception until June 2023. Abstracts and full text were screened against eligibility criteria. Extracted data included study characteristics, ToC service descriptions, primary and secondary outcomes, limitations, and key findings. Study findings were synthesised narratively. The types of in-patient and post-discharge activities and their effect on patient outcomes were critiqued and presented.
Results: Of the 1822 studies identified, 37 were included in the final review. The most common primary outcome reported was 30-day all cause readmissions (n=14). Pharmacist-led ToC services incorporated a diverse combination of inpatient and post-discharge activities. The most common in-patient activities included medication history and reconciliation, patient medication education, and medication review and optimisation. The most common post-discharge activities were medication review and optimisation, adherence assessments, and medication education. Multifaceted ToC services that involved inpatient and post-discharge activities demonstrated statistically significant changes in readmission rates and other patient reported outcomes.
Conclusion: A variety of multifaced approaches to pharmacist-led ToC services have been evaluated within many studies, reporting favourable effects on outcomes for patients with cardiovascular disease. Tailoring ToC services to specific patient populations and settings, targeting activities to high-risk patients, and a multidisciplinary approach, are important to optimise ToC and patient outcomes.
期刊介绍：
''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.
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