Arti Phatak|Rachael Prusi|Brooke Ward|Luke O. Hansen|Mark Williams|Elizabeth Vetter|Noelle R. M. Chapman|Michael Postelnick
Impact of pharmacist involvement in the transitional care of high?risk patients through medication reconciliation, medication education, and postdischarge call?backs (<scp>IPITCH</scp> Study)
Northwestern Memorial Hospital|Northwestern Memorial Hospital|Northwestern Memorial Hospital|Northwestern University|University of Kentucky|Northwestern Memorial Hospital|Northwestern Memorial Hospital|Northwestern Memorial Hospital
background previous data suggest direct pharmacist interaction patients medication reconciliation discharge counseling postdischarge phone calls decreases number adverse drug events ades plays overall positive role transitional care previous studies evaluated pharmacist involvement improving transitional care studies include multiple postdischarge followup phone calls objectives objectives study assess impact pharmacist involvement transitions care measured decreased medication errors mes ades patients knowledge related communication medications measured improvement hospital consumer assessment healthcare providers systems hcahps scores 30day allcause inpatient readmissions emergency department ed visits methods prospective randomized singleperiod longitudinal study occurred november 2012 june 2013 urban tertiary academic medical center patients admitted 2 designated internal medicine units highrisk medications greater 3 prescription medications upon discharge included randomization control group received usual hospital standard care study group received facetoface medication reconciliation patientspecific pharmaceutical care plan discharge counseling postdischarge phone calls days 3 14 30 provide education assess study endpoints results total 278 patients included final analysis 141 control group 137 study group fiftyfive patients 39 control arm experienced inpatient readmission ed visit within 30days postdischarge compared 34 patients 248 study arm p 001 eighteen patients 128 control group experienced ades mes compared 11 patients 8 study group p gt 005 hcahps scores study period showed 9 improvement assessed questionnaire domain p gt 005 conclusions study demonstrated pharmacist involvement hospital discharge transitions care positive impact decreasing composite inpatient readmissions ed visits statistically significant difference medicationrelated events hcahps scores observed patients moderately complex medication regimens benefited continuity care involving pharmacy team transitions care journal hospital medicine 2016113944 2015 society hospital medicine