Impact of Pharmacy Student-Led Medication Counseling for New Start Anticoagulants on Patient Outcomes and Healthcare Utilization.

Abstract

Purpose: While there is evidence that pharmacist-led medication counseling improves patient safety and outcomes, there is conflicting evidence of the impact of pharmacy students on patient care outcomes. The objective of this study is to investigate if pharmacy student-led new-start anticoagulant medication counseling has a similar effect on healthcare utilization compared to pharmacist-led new start anticoagulant medication counseling. Methods: This study is a multicenter retrospective cohort study. The primary outcome is a composite of unplanned patient contact (phone call or MyChart message) with healthcare providers, emergency department (ED) visits, and hospital readmission within 30 days of discharge. Patients at least 18 years old that are newly started on apixaban, rivaroxaban, or warfarin for a new pulmonary embolism or deep vein thrombosis were included. Student- and pharmacist-led counseling data was collected from seven medical centers in central Texas between January 1, 2022 and June 30, 2023 via chart review on Epic. Results: There were 575 patients included in this study. Of these, 165 (29%) patients were counseled by students, 84 (15%) patients were counseled by pharmacists, and 326 (57%) patients were not counseled at all. 440 (77%) patients had unplanned patient contact, ED visit, and/or readmission within 30 days of discharge. There was no difference in all-cause (p = 0.78) or bleeding-related (p = 0.23) composite unplanned patient contact, ED visits, and readmissions within 30 days of discharge between student- and pharmacist-led counseling. Conclusion: This study suggests that student-led versus pharmacist-led anticoagulant counseling shows no difference in patient outcomes and healthcare utilization.