Improving Post Discharge Medication Adherence: A Collaboration between an Academic Medical Center and a Community Pharmacy Chain..

摘要

Objective: To describe a collaborative transition of care service (TOC) model between an academic hospital and a community pharmacy chain. Methods: Eligible patients included hospitalized adults who had one or more discharge prescriptions sent to one of the designated community pharmacies. Discharge medication lists were faxed from the hospital to each patient’s preferred community pharmacy. Patients who had not picked up their discharge medications after 24 hours were called by a community pharmacy resident or intern. The purpose of the call was to encourage patients to pick up their discharge medications and to stress the importance of medication adherence. The community pharmacy resident or intern used the faxed discharge medication list to update the community pharmacy medication profile and deactivated medications that were discontinued post hospitalization. Results: The collaborative TOC service began February 2016 and included 22 patients through April 2016. A total of 15 patients picked up their medications within 24 hours post discharge. Of the seven patients who did not pick up their medications with 24 hours, four patients were successfully reached by pharmacy and picked up their medications between 24-48 hours post discharge. Each call lasted two to four minutes. Key lessons learned included providing a robust training program for pharmacy staff at participating community pharmacies and for residents at the hospital prior to and during service implementation. Barriers encountered included difficulty contacting patients, unable to change active prescriptions for medications that are modified during hospitalization, and the process of manually identifying discharge patients. Conclusion: A collaborative TOC service between an academic hospital and a community pharmacy is a feasible model that can be adopted by other institutions seeking to improve TOC upon hospital discharge. Further study is needed to assess the impact of this unique model on time to discharge medication pick up, adherence, and hospital readmissions.