A Pharmacist-led Transitions of Care Program

The Impact of a Pharmacist-Led Transitional Care Program on Health Outcomes of Uninsured Populations

This study was to show the value of pharmacists in providing transitions of care to and improving health outcomes of uninsured populations. It also aimed to demonstrate the feasibility of implementing a transitions of care program in an indigent care clinic with limited resources. We hypothesized that a pharmacist-led transitions of care program will reduce 30-day hospital readmission rates among the uninsured discharged from a community hospital.

Study Overview

• Status: Completed
• Conditions: Chronic Disease
• Intervention / Treatment: Behavioral: Transitions of care

• Study Type: Interventional
• Enrollment (Actual): 88
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Auburn, Alabama, United States, 36830
      • Mercy Medical Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Aged 18 years old or older
• Uninsured
• English speaking
• Discharged from East Alabama Medical Center within the past 16 days

Exclusion Criteria:

• Patients who did not show up for the first follow-up visit with the study pharmacist after being referred by the care coordinator at East Alabama Medical Center

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Transitions of care; The study participants in this aim received usual care plus medication reconciliation, daily schedule for medication taking and medical condition monitoring, and follow-up phone calls from a pharmacist.	Behavioral: Transitions of care; The intervention was a pharmacist-led transitions of care program that include medication reconciliation, daily schedule for medication taking and medical condition monitoring, and follow-up phone calls from a pharmacist at 60- and 90-day post-discharge in addition to the usual care.
No Intervention: Usual care; The study participants in this arm received usual care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
30-day hospital readmission	Whether a study participant had any hospital readmission 30-day post-discharge	30-day post-discharge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
60-day hospital readmission	Whether a study participant had any hospital readmission 60-day post-discharge	60-day post-discharge
90-day hospital readmission	Whether a study participant had any hospital readmission 90-day post-discharge	90-day post-discharge
30-day emergency department (ED) visit	Number of ED visits among study participants in each study arm 30-day post-discharge	30-day post-discharge
60-day emergency department (ED) visit	Number of ED visits among study participants in each study arm 60-day post-discharge	60-day post-discharge
90-day emergency department (ED) visit	Number of ED visits among study participants in each study arm 90-day post-discharge	90-day post-discharge
30-day follow-up visit with a primary care provider	Did a study participant keep a follow-up appointment with a primary care provider	30-day post-discharge

Collaborators and Investigators

• Sponsor: Auburn University
• Investigators: Principal Investigator: Chiahung Chou, PhD, Auburn University

Publications and helpful links

General Publications

• Englander H, Kansagara D. Planning and designing the care transitions innovation (C-Train) for uninsured and Medicaid patients. J Hosp Med. 2012 Sep;7(7):524-9. doi: 10.1002/jhm.1926. Epub 2012 Mar 12.
• Hawes EM, Maxwell WD, White SF, Mangun J, Lin FC. Impact of an outpatient pharmacist intervention on medication discrepancies and health care resource utilization in posthospitalization care transitions. J Prim Care Community Health. 2014 Jan 1;5(1):14-8. doi: 10.1177/2150131913502489. Epub 2013 Sep 17.
• Crotty M, Rowett D, Spurling L, Giles LC, Phillips PA. Does the addition of a pharmacist transition coordinator improve evidence-based medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial. Am J Geriatr Pharmacother. 2004 Dec;2(4):257-64. doi: 10.1016/j.amjopharm.2005.01.001.
• Phatak A, Prusi R, Ward B, Hansen LO, Williams MV, Vetter E, Chapman N, Postelnick M. Impact of pharmacist involvement in the transitional care of high-risk patients through medication reconciliation, medication education, and postdischarge call-backs (IPITCH Study). J Hosp Med. 2016 Jan;11(1):39-44. doi: 10.1002/jhm.2493. Epub 2015 Oct 5.

Helpful Links

• Key Facts about the Uninsured Population
• America's Health Rankings

Study record dates

Study Major Dates

• Study Start (Actual): October 2, 2018
• Primary Completion (Actual): July 16, 2019
• Study Completion (Actual): July 16, 2019

Study Registration Dates

• First Submitted: September 15, 2020
• First Submitted That Met QC Criteria: September 18, 2020
• First Posted (Actual): September 21, 2020

Study Record Updates

• Last Update Posted (Actual): September 21, 2020
• Last Update Submitted That Met QC Criteria: September 18, 2020
• Last Verified: September 1, 2020

More Information

Terms related to this study

• Keywords: Transitions of care; Indigent population; Hospital readmission rates
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Chronic Disease
• Other Study ID Numbers: 18-342 EX 1809

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No