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Discharge Counseling for Patients with Heart Failure or Myocardial Infarction: A Best Practices Model Developed by Members of the American College of Clinical Pharmacy's Cardiology Practice and Research Network Based on the Hospital to Home ( H 2 H ) Initiative
Author(s) -
Wiggins Barbara S.,
Rodgers Jo E.,
DiDomenico Robert J.,
Cook Abigail M.,
Page Robert L.
Publication year - 2013
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1231
Subject(s) - medicine , myocardial infarction , pharmacy , adverse effect , heart failure , intensive care medicine , emergency department , clinical pharmacy , health care , pharmacotherapy , medical emergency , emergency medicine , family medicine , nursing , economics , economic growth
Hospital to Home is a quality‐based initiative led by the A merican C ollege of C ardiology and the I nstitute for H ealthcare I mprovement, aimed at reducing 30‐day hospital readmission rates for patients with heart failure or myocardial infarction. Several factors have been shown to attribute to early readmission for these conditions including comorbidities, environmental factors, insufficient discharge planning, lack of health literacy, and nonadherence to drug therapy. Pharmacists play a significant role in reducing readmissions by ensuring that appropriate evidence‐based pharmacotherapy regimens have been prescribed during hospitalization; monitoring for drug duplications, medication errors, and adverse reactions; and performing medication reconciliation. Studies have demonstrated the role of pharmacists in reducing medication‐related visits to the emergency department as well as hospital readmissions, solely by preventing adverse drug events. Although all of these factors impact early readmissions, providing quality counseling to the patient as well as the patients' caregiver(s) at discharge is critical in order to optimize adherence as well as outcomes. In order to accomplish the goal of reducing readmissions, health care providers must partner together across the continuum of care and include pharmacists as pivotal members of the health care team. In this best practice statement, we summarize key components of discharge counseling for patients with heart failure or myocardial infarction including medication use, medication dose and frequency, drug interactions, medications to avoid, common adverse effects, role of the medication in the disease state, signs and symptoms of the disease, diet, the patient's role in self‐care (lifestyle modifications), and when patients should seek medical advice.