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This study was to show the value of pharmacists in providing transitions of care to and improving health outcomes of uninsured populations. It also aimed to demonstrate the feasibility of implementing a transitions of care program in an indigent care clinic with limited resources. We hypothesized that a pharmacist-led transitions of care program will reduce 30-day hospital readmission rates among the uninsured discharged from a community hospital.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Transitions of care | Experimental | The study participants in this aim received usual care plus medication reconciliation, daily schedule for medication taking and medical condition monitoring, and follow-up phone calls from a pharmacist. |
|
| Usual care | No Intervention | The study participants in this arm received usual care. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transitions of care | Behavioral | The intervention was a pharmacist-led transitions of care program that include medication reconciliation, daily schedule for medication taking and medical condition monitoring, and follow-up phone calls from a pharmacist at 60- and 90-day post-discharge in addition to the usual care. |
| Measure | Description | Time Frame |
|---|---|---|
| 30-day hospital readmission | Whether a study participant had any hospital readmission 30-day post-discharge | 30-day post-discharge |
| Measure | Description | Time Frame |
|---|---|---|
| 60-day hospital readmission | Whether a study participant had any hospital readmission 60-day post-discharge | 60-day post-discharge |
| 90-day hospital readmission | Whether a study participant had any hospital readmission 90-day post-discharge |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chiahung Chou, PhD | Auburn University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mercy Medical Clinic | Auburn | Alabama | 36830 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22411913 | Background | Englander H, Kansagara D. Planning and designing the care transitions innovation (C-Train) for uninsured and Medicaid patients. J Hosp Med. 2012 Sep;7(7):524-9. doi: 10.1002/jhm.1926. Epub 2012 Mar 12. | |
| 24327590 | Background | Hawes EM, Maxwell WD, White SF, Mangun J, Lin FC. Impact of an outpatient pharmacist intervention on medication discrepancies and health care resource utilization in posthospitalization care transitions. J Prim Care Community Health. 2014 Jan 1;5(1):14-8. doi: 10.1177/2150131913502489. Epub 2013 Sep 17. |
| Label | URL |
|---|---|
| Key Facts about the Uninsured Population | View source |
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| ID | Term |
|---|---|
| D002908 | Chronic Disease |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D010360 | Patient Transfer |
| ID | Term |
|---|---|
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006760 | Hospitalization |
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|
| 90-day post-discharge |
| 30-day emergency department (ED) visit | Number of ED visits among study participants in each study arm 30-day post-discharge | 30-day post-discharge |
| 60-day emergency department (ED) visit | Number of ED visits among study participants in each study arm 60-day post-discharge | 60-day post-discharge |
| 90-day emergency department (ED) visit | Number of ED visits among study participants in each study arm 90-day post-discharge | 90-day post-discharge |
| 30-day follow-up visit with a primary care provider | Did a study participant keep a follow-up appointment with a primary care provider | 30-day post-discharge |
| 15903284 | Background | Crotty M, Rowett D, Spurling L, Giles LC, Phillips PA. Does the addition of a pharmacist transition coordinator improve evidence-based medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial. Am J Geriatr Pharmacother. 2004 Dec;2(4):257-64. doi: 10.1016/j.amjopharm.2005.01.001. |
| 26434752 | Background | Phatak A, Prusi R, Ward B, Hansen LO, Williams MV, Vetter E, Chapman N, Postelnick M. Impact of pharmacist involvement in the transitional care of high-risk patients through medication reconciliation, medication education, and postdischarge call-backs (IPITCH Study). J Hosp Med. 2016 Jan;11(1):39-44. doi: 10.1002/jhm.2493. Epub 2015 Oct 5. |
| America's Health Rankings | View source |
| D006296 |
| Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| D011320 | Primary Health Care |
| D003191 | Comprehensive Health Care |
| D010346 | Patient Care Management |
| D006298 | Health Services Administration |