Pharmacist-led transitions-of-care services in primary care settings: Opportunities, experiences, and challenges

Abstract Individuals with subthreshold borderline personality disorder (BPD) are commonly encountered in primary care settings, yet the psychological treatments they receive are rarely tailored to their needs. In an effort to capture and treat this group of individuals in a targeted and meaningful way, some primary care settings offer Systems Training for Emotional Predictability and Problem Solving – Emotional Intensity (STEPPS-EI). This evaluation sought to assess the feasibility of STEPPS-EI within NHS primary care services. Employing an uncontrolled design, the evaluation examined recruitment, retention, effectiveness and group appraisal. Findings supported three out of four evaluation objectives for feasibility: uptake of the group was high at 74%, the group was well received by the group and significantly effective at reducing symptoms of BPD, depression and anxiety. However, retention rates were low, with only 43% classed as ‘completers’ of the programme. The results indicate preliminary evidence for STEPPS-EI as a potentially feasible intervention with possible modification to enhance retention and avenues for further study. Key learning aims After reading this paper, the reader will be aware of: (1) Recent developments in the classification and diagnosis of personality disorder leading to the conceptualisation of subthreshold presentations. (2) The feasibility of conducting a primary care intervention for individuals with emotional intensity difficulties. (3) The preliminary beneficial outcomes of utilising a primary care intervention for individuals with emotional intensity difficulties. (4) Potential issues for participants and providers of primary care programmes with future direction for improvement and implementation.

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A Comparison of Waiting Times, Patient Choice and Satisfaction in Three Primary Care Settings

Australian Journal of Primary Health ◽

10.1071/py03008 ◽

2003 ◽

Vol 9 (1) ◽

pp. 68 ◽

Cited By ~ 1

Author(s):

Patrick Boltonl ◽

Michael Mira

Keyword(s):

Primary Care ◽

Health Care ◽

Patient Satisfaction ◽

Waiting Time ◽

Waiting Times ◽

Patient Choice ◽

Care Services ◽

Primary Care Settings ◽

Primary Care Services ◽

Choice Of Care

The objective of this study was to examine the interaction between patients' choice of care, their satisfaction with that care, and waiting time. Patient satisfaction and waiting times were recorded in three primary care settings in Sydney. The results show that patients in Australian primary care services do not like to wait, and those for whom waiting time is a determinant of choice are easier to satisfy than those for whom it is not, irrespective of the wait. Primary care services may be made be made more satisfying for consumers if consumers are better engaged in choosing their health care.

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Evolution of Interdisciplinary Transition of Care Services in a Primary Care Organization

Pharmacy ◽

10.3390/pharmacy7040164 ◽

2019 ◽

Vol 7 (4) ◽

pp. 164

Author(s):

William J. Hitch ◽

Irene Park Ulrich ◽

Anne C. Warren ◽

Dow Stick ◽

Danielle Leyonmark ◽

...

Keyword(s):

Primary Care ◽

Hospital Readmissions ◽

Interdisciplinary Team ◽

Transitions Of Care ◽

Care Organization ◽

Transition Of Care ◽

Future Directions ◽

Care Services ◽

Care Processes ◽

Successes And Challenges

Transitions of care create complex management challenges for providers and leave patients vulnerable to medication errors and hospital readmissions. This article examines the evolution of an interdisciplinary team of pharmacists and nurse care managers and their impact on safe and effective transitions from the acute care settings back into primary care. This article explores successes and challenges of this primary-care-based clinic in managing patients safely through often-complex situations, and explores future directions for improving care processes and outcomes.

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Lost in Transition: Pharmacist Roles in Identifying and Evaluating Medication-Related Problems During Hospital Discharge Follow-up Visits in a Primary Care Setting

Journal of Primary Care & Community Health ◽

10.1177/2150132720917297 ◽

2020 ◽

Vol 11 ◽

pp. 215013272091729

Author(s):

Alexis Dellogono ◽

Aimee Dawson ◽

Marisa Piers-Gamble ◽

Jerril Varghese ◽

Lori Lewicki

Keyword(s):

Primary Care ◽

Hospital Discharge ◽

Care Setting ◽

Adverse Drug Events ◽

Primary Care Setting ◽

Health Care Team ◽

Care Team ◽

Transitions Of Care ◽

Primary Care Settings

Objectives: The objective of this study was to identify and evaluate medication-related problems (MRPs) found during hospital discharge transitions of care visits in a primary care setting. Design, Settings, and Participants: This retrospective cohort took place within a federally qualified health center (FQHC) where pharmacists are part of the interprofessional transitions of care team to help patients transition back to primary care after being discharged from the hospital. Pharmacists utilized standardized forms to document MRPs, potential and adverse drug events, and interventions made during the visit. This study quantifies the role that pharmacists can have by conducting medication reconciliation during postdischarge primary care visits. Patients included in this study were 18 years and older with at least 5 medications. Outcome Measures: The outcomes of this study include the number and type(s) of MRPs, number and severity of potential adverse drug events (pADEs) and adverse drug events (ADEs) that were identified, as well as the number and type of recommendations or interventions made by the pharmacist. The MRP types and pADE/ADE severity were classified and stratified using predetermined definitions. Results: During the 4-month study period from October 1, 2018 to February 4, 2019, 134 visits were completed. Outcomes included a total of 454 MRPs, with an average of 3 identified per visit. The most common MRPs were medication list in electronic health record inaccurate (79.1% of visits), poor adherence (32.1% of visits), and refills needed (30.6% of visits). A total of 72 pADEs and 27 ADEs were identified, with 524 recommendations made. Conclusion: Pharmacists serve a unique role during transitions of care by identifying MRPs. Pharmacists are an integral part of a patient’s health care team by making recommendations or interventions related to these MRPs. FQHCs and other primary care settings should consider integrating pharmacists into a collaborative transitions of care team.

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Preface

Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) ◽

10.22146/rpcpe.62773 ◽

2021 ◽

Vol 3 (3) ◽

pp. 1

Author(s):

Hari Kusnanto

Keyword(s):

Primary Care ◽

Information And Communication Technology ◽

Communication Technology ◽

Health Care Workers ◽

Remote Consultation ◽

Care Services ◽

Primary Care Settings ◽

Primary Care Services ◽

Care Workers ◽

Information And Communication

The Roles of Primary Care Services in the Midst of Covid-19 PandemicsIt is generally understood that the majority of health problems could be solved in primary care settings. Pandemics due to Covid-19 brings about more complexities in primary care services. Health care workers should protect themselves by minimizing physical contacts with patients and coworkers. A frequent option now is teleconsultation or remote consultation, typically using internet. Teleconsultation is asynchronous or synchronous consultation using information and communication technology, mainly for diagnostic and therapeutic purposes.

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