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Medication management through pharmacist‐provided home‐based services
Author(s) -
Pherson Emily,
Swarthout Meghan,
Fu Denise,
Barbour Lauren,
Green Robert,
Ross Patricia,
Nesbit Todd
Publication year - 2020
Publication title -
journal of the american college of clinical pharmacy
Language(s) - English
Resource type - Journals
ISSN - 2574-9870
DOI - 10.1002/jac5.1225
Subject(s) - pharmacist , medicine , medication therapy management , documentation , cohort , family medicine , descriptive statistics , socioeconomic status , retrospective cohort study , pharmacy , medical emergency , population , statistics , mathematics , environmental health , computer science , programming language
Pharmacists play an important role in helping patients manage their medications across the continuum of care. Pharmacist home visits support continuity of care and provide a unique opportunity to identify medication‐related problems. Objective The primary objective of this study was to describe a cohort of patients who received home visits and the subsequent actions taken by the pharmacist towards the goal of optimizing medication regimens. The evolution of the service is also described. Methods A retrospective chart review was used to gather demographic information. Clinical documentation was reviewed to gather information on medication problems identified by the pharmacist and recommendations made to prescribers. Institutional and city databases were used to collect data on readmissions and socioeconomic status, respectively. Descriptive statistics were used to analyze data. Results Between February 2012 and December 2018, 485 home visits were conducted. Patients were taking a mean of 13 (SD ±5.5) medications; 1890 medication discrepancies were identified and 862 recommendations were made to prescribers. The relative risk reduction in readmissions for those patients who received a home visit was 6.6%. The average yearly income for citizens who live in neighborhoods where many of the home visits took place was $37 000. Details regarding the evolution of the home visit service were described. Conclusions A large cohort of 485 home visits demonstrated that medications are often not being taken as prescribed, and that the pharmacist is in a unique position to educate patients and work with providers toward the goal of optimizing medication regimens and behaviors. This model of care, focused on high‐risk patients, has been sustained over 7 years. Ongoing efforts are underway to improve communication with prescribers, increase the referral to home visit conversion rate, and enhance longitudinal outcome tracking. Opportunity exists to further expand the service through partnerships with regional payers.