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Enhanced communication between inpatient and community pharmacists to optimize medication management during transitions of care

Published:October 03, 2018DOI:https://doi.org/10.1016/j.japh.2018.09.006

      Abstract

      Objectives

      To describe the Pharmacy Communication Partnership (PROMPT) program’s approach to improving medication management for patients during transitions from hospital to the community.

      Setting

      Two general internal medicine units within a multisite academic hospital in Canada.

      Practice innovation

      Designed by an interprofessional working group, PROMPT uses evidence-informed approaches to facilitate communication between pharmacists in different settings: faxing of the discharge prescription and medical discharge summary to a patient’s community pharmacy, followed by a telephone call to the community pharmacist.

      Evaluation

      A multimethod cross-sectional study used telephone surveys and retrospective chart reviews to describe: 1) the characteristics of patients that hospital pharmacists thought would benefit from PROMPT and the community pharmacies that served them; 2) the number and nature of communication attempts made by community and hospital pharmacists; and 3) community pharmacists’ views about PROMPT’s potential impact on continuity of care and potential program enhancements.

      Results

      A convenience sample of 100 patients (median age 77 years, interquartile range 66 to 83) who received care from 86 pharmacies were used to evaluate the program. The majority of community pharmacists participating in the surveys considered the intervention to be helpful. Of the 53.7% (n = 44/82) community pharmacists who received discharge summaries, 93.2% (n = 41/44) found the summaries to be useful. Themes arising from community pharmacists’ comments were categorized into 3 topics: 1) the benefits of PROMPT; 2) topics of discussion and clarification during telephone calls with hospital pharmacists; and 3) future program improvements.

      Conclusion

      Community pharmacists described PROMPT as a time-efficient and helpful bridge linking community pharmacy to hospital inpatient care. Opportunities for future research include determining the characteristics of patients who may benefit most from PROMPT, determining the optimal components of discharge information needed by community pharmacists to enhance medication management, and evaluating whether follow-up telephone calls from the hospital to community pharmacists are necessary for all patients.
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      Biography

      Lisa M. McCarthy, BScPhm, PharmD, MSc, Clinician Scientist, Women’s College Research Institute at Women’s College Hospital, Toronto, Ontario; Assistant Professor, Leslie Dan Faculty of Pharmacy and Department of Family and Community Medicine, University of Toronto, Toronto, Ontario

      Biography

      Sonja Li, PharmD, PharmD student, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario

      Biography

      Olavo Fernandes, BScPhm, PharmD, Director of Pharmacy—Clinical and Operations, Assistant Professor, Leslie Dan Faculty of Pharmacy, Centre for Patient Safety, and Centre for Interprofessional Education, University of Toronto, Toronto, Ontario

      Biography

      Karen Cameron, BScPhm, Adjunct Lecturer, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario; at time of study: Education Coordinator, University Health Network, Toronto, Ontario

      Biography

      Philip Lui, BScPhm, PharmD, Pharmacy Clinical Site Leader, University Health Network, Toronto, Ontario

      Biography

      Gary Wong, BScPhm, Clinical Manager, University Health Network, Toronto, Ontario; Assistant Professor, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario

      Biography

      Pauline Pariser, MD CCFP, FCFP, Associate Professor, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario

      Biography

      John Farrell, Executive Director, Centre for Practice Excellence, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario (at the time of study)

      Biography

      Miles J. Luke, BSc, PharmD, Research Associate, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario

      Biography

      Sara J.T. Guilcher, BSc(Hons), MScPT, MSc, PhD, Assistant Professor, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario; Scientist, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario