Key result
Pharmacist-led transitions of care link to lower CAD readmissions and better medication adherence.
Why the study?
Patients with coronary artery disease frequently experience hospital readmissions, and the impact of pharmacist-driven transitions of care interventions on post-hospital outcomes remains to be systematically evaluated.
Systematic Review (n=3,024)
Answers are grounded in this paper and cite their sources.
Supports pharmacist involvement in CAD transitions; extends limited data but leaves randomized confirmation open.
Background: Transitions of care (ToC) aim to provide continuity while preventing loss of information that may result in poor outcomes such as hospital readmission. Readmissions not only burden patients, they also increase costs. Given the high prevalence of coronary artery diseases (CAD) in the United States (US), patients with CAD often make up a significant portion of hospital readmissions. Objective: To conduct a systematic review evaluating the impact of pharmacist-driven ToC interventions on post-hospital outcomes for patients with CAD. Methods: MEDLINE, Scopus, and CINAHL were searched from database inception through 03/2020 using key words for CAD and pharmacists. Studies were included if they: (1) identified adults with CAD at US hospitals, (2) evaluated pharmacist-driven ToC interventions, and (3) assessed post-discharge outcomes. Outcomes were summarized qualitatively. Results: Of the 1612 citations identified, 11 met criteria for inclusion. Pharmacist-driven ToC interventions were multifaceted and frequently included medication reconciliation, medication counseling, post-discharge follow-up and initiatives to improve medication adherence. Hospital readmission and emergency room visits were numerically lower among patients receiving vs not receiving pharmacist-driven interventions, with statistically significant differences observed in 1 study. Secondary prevention measures and adherence tended to be more favorable in the pharmacist-driven intervention groups. Conclusion: Eleven studies of multifaceted, ToC interventions led by pharmacists were identified. Readmissions were numerically lower and secondary prevention measures and adherence were more favorable among patients receiving pharmacist-driven interventions. However, sufficiently powered studies are still required to confirm these benefits.
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Weeda et al. (2021) conducted a systematic review in Coronary Artery Disease (CAD) (n=3,024). Pharmacist-driven transitions of care interventions vs. Usual care or historical controls was evaluated on Post-hospital outcomes (hospital readmissions, emergency room visits, mortality, secondary prevention measures, and medication adherence). Pharmacist-driven transitions of care interventions for patients with coronary artery disease were associated with numerically lower hospital readmissions and more favorable medication adherence.
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