Experience with technology-supported transitions of care to improve medication use
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OBJECTIVE: To describe an innovative community pharmacy-based pilot program using technology to support transitions of care for patients living in rural areas. SETTING: This service occurred through a partnership between 1 independent community pharmacy organization with 5 locations in Ohio and Indiana and one 92-bed general medical and surgical county hospital during May 2014 to May 2015. PRACTICE DESCRIPTION AND INNOVATION: Community pharmacists worked with patients immediately following discharge to reconcile their medications and make recommendations to optimize therapy. The pharmacy packaged their new medication regimen in clear, individual dose adherence packaging. Medications were delivered by a staff driver to the patient's home within 72 hours of discharge. Patients consulted with the pharmacist by videoconference using a computer tablet device. Patients received telephone follow-up shortly before their medication supply was to run out, and additionally as needed on an individual basis. EVALUATION: Self-reported hospital readmissions were collected at 30 and 180 days after enrollment. Patient satisfaction data were also collected at 30 and 180 days using a tool modified from the 5-item Transition Measure (15-item Care Transitions Measure). RESULTS: Eighteen patients participated in the evaluation of the pilot. Three patients were readmitted within 30 days (17%), and 2 additional patients were readmitted within 180 days (11%). Patient satisfaction results were positive overall. Lessons learned relate to establishing partnerships, logistics, and patient engagement. These lessons will assist future community pharmacies in implementing a transition of care service. CONCLUSION: This pharmacist care model may offer a solution to increase access to pharmacy services for patients in rural areas during a critical transition in care.
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