A Pharmacist-led Transitions of Care Program

Auburn University88 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Chronic Disease

Interventions

Transitions of careBEHAVIORAL

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.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged 18 years old or older * Uninsured * English speaking * Discharged from East Alabama Medical Center within the past 16 days Exclusion Criteria: * Patients who did not show up for the first follow-up visit with the study pharmacist after being referred by the care coordinator at East Alabama Medical Center

Locations (1)

Mercy Medical Clinic

Auburn, Alabama, United States

Outcomes

Primary Outcomes

30-day hospital readmission

Whether a study participant had any hospital readmission 30-day post-discharge

Time frame: 30-day post-discharge

Secondary Outcomes

60-day hospital readmission

Whether a study participant had any hospital readmission 60-day post-discharge

Time frame: 60-day post-discharge

90-day hospital readmission

Whether a study participant had any hospital readmission 90-day post-discharge

Time frame: 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

Time frame: 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

Time frame: 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

Time frame: 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

Time frame: 30-day post-discharge

Data from ClinicalTrials.gov

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