COMPARING SERVICE MODELS: PHARMACIST-ASSISTED TRANSITION OF CARE (TOC) VERSUS STANDARD OF CARE (SOC) TOWARDS EFFECT ON HEALTHCARE RESOURCE UTILIZATION AMONG PATIENTS FROM MEDICAL WARDS

Received 2020-10-17; Accepted 2021-09-15; Published 2021-10-10

Authors

  • Yap Fui Sing Diana Pharmacy Department, Hospital Enche’ Besar Hajjah Khalsom, Kluang, Johor, Ministry of Health, Malaysia.
  • Nur Alyaa Khairudin Pharmacy Department, Hospital Enche’ Besar Hajjah Khalsom, Kluang, Johor, Ministry of Health, Malaysia.
  • Nurul Dinah Afiqah Sabarudin Pharmacy Department, Hospital Enche’ Besar Hajjah Khalsom, Kluang, Johor, Ministry of Health, Malaysia.
  • Sin Wei Wong Pharmacy Department, Hospital Enche’ Besar Hajjah Khalsom, Kluang, Johor, Ministry of Health, Malaysia.

DOI:

https://doi.org/10.22452/jummec.vol25no1.5

Keywords:

Transition of care, Healthcare resource utilization, Bedside dispensing, Medication reconciliation, Readmission

Abstract

Introduction: Suboptimal care transition post-discharge may potentially increase subsequent healthcare system utilization. Transition of care is a service approach to support continuum of patient care after discharge. Objectives: This study aimed to compare the effect of pharmacist-assisted transition of care versus standard care models towards healthcare resource utilization among medical ward patients.

Methods: A cluster randomized controlled study was conducted among medical ward patients in a Malaysian secondary hospital from July to December 2019. Intervention group received pharmacist-assisted discharge medication reconciliation, bedside discharge medication delivery with counselling and a timely post-discharge callback. Control group followed standard discharge process with medication collection at ambulatory pharmacy without post-discharge phone calls. Study endpoints included pharmacy first refill persistency, resolution on unintended discharge medication discrepancies and 30-days all-cause rehospitalization.

Results: A total of 168 patients with 84 patients in each arm were recruited. Intervention resulted a higher pharmacy first refill persistency (70.2% versus 50.0%, p<0.05), indicating a lowering in subsequent unscheduled refill rate. Under intervention, consistent rate of resolution from discrepancies (100.0%, IQR 0 versus 100.0%, IQR 67; p<0.05) was demonstrated that corresponded to medication cost-savings of RM6.80 per prescription over control. Unplanned rehospitalization was not significantly different between groups (p>0.05) but towards a trend of 10% reduction after intervention.

Conclusion: Pharmacist-led transition care model demonstrated promising effect towards a reduction in healthcare resource use compared to standard care. Future studies for its standardization across institutions are warranted to facilitate service expansion.

Downloads

Download data is not yet available.

Downloads

Published

2022-01-20

Issue

Section

Research article