Impact of Pharmacist Counseling at Discharge for Older People

Objective To examine the evidence surrounding how the implementation of pharmacist discharge counseling affects the number of readmissions. Data Sources A search was conducted using EBSCOhost and the National Library of Medicine databases for articles published through December 2020 with the keywords “discharge counseling,” “discharge teaching,” “discharge education,” “patient education,” “patient teaching,” “medication reconciliation,” “pharmacist,” and “readmission rates.” The authors independently screened citations and applied inclusion and exclusion criteria. Study Selection A total of 32 articles were reviewed and analyzed. Inclusion criteria included articles published in the English language with human subjects, and adults (18 years of age and older) involving pharmacist-led discharge counseling and assessment of readmission rates were included. Data Extraction Study characteristics, intervention type, and outcomes with statistical significance where reported were included in the literature analysis. Data Synthesis Studies examined reported varying health care improvements postdischarge with the implementation of pharmacist services in the discharge process. Not all results were significant for reduction in readmission rates, but a downward trend was observed. Conclusion Implementation of pharmacist discharge counseling may decrease the number of hospital readmissions, particularly in older people.

PENGARUH BRIEF CONSELING FARMASIS DALAM PENINGKATAN PERILAKU DAN KEPATUHAN MINUM OBAT DI RSUD ULIN BANJARMASIN

Hypertension is one of the deadliest diseases in the world. As many as 1 billion people in the world or 1 in 4 adults suffer from this disease. Patient behavior by controlling the patient's blood pressure will help achieve the success of patient therapy. The purpose of this study was to determine the Brief Effect of Pharmacist Counseling in Improving Behavior and Adherence to at Ulin Hospital, Banjarmasin. The study was a quasi-experimental study using two groups. The sampling method was carried out by counsecutive sampling with simple random that met the inclusion and exclusion criteria. The sample in this study was 60 samples with 30 samples from the control group and 30 samples from the intervention group. This research was conducted at the Internal Medicine Polyclinic at Ulin Hospital from March-June 2020. The data collection technique used in this study was a questionnaire on the level of treatment behavior, the MMAS (Morisky Medication Adherence Scale) and EQ5D (Euro Quality of Life) compliance questionnaire. The results of this study were brief pharmacist counseling in improving behavior, medication adherence and the results of hypertension therapy at RSUD Ulin Banjarmasin which had a positive effect on the intervention group.

Improving direct pharmacist counseling rates for oral oncolytic medications at an outpatient oncology clinic

Background Due to the increasing prevalence of oral oncolytic utilization for patients with malignancy, implementation of strategies for increased monitoring and patient safety have become a necessity. Our focus was on the American Society of Clinical Oncology’s Quality Oncology Practice Initiative (QOPI) standards of care, standard 2.3, and its requirement for patient counseling prior to first administration of oral oncolytic therapy. Objective To assess the implementation of a workflow improvement strategy to determine its effect on the number of patients reached for pharmacist counseling prior to first dose of oral oncolytic medications. Methods In this quasi-experimental quality improvement study, we formed a multidisciplinary group to develop and implement a workflow improvement process. This process was focused on a redistribution of workflow and the implementation of new technology within EPIC Beacon. Results A total of 86 patients were identified as eligible for counseling (38 pre-intervention, 48 post-intervention). There was a statistically significant increase in number of eligible patients counseled in the post-intervention period as compared to the pre-intervention period (100% vs. 86.84%; 95% CI = –0.212, –0.205; P = 0.017). There were no significant differences observed in the number of patients counseled in-person or patients counseled prior first dose. Conclusion Our intervention showed a 100% rate of counsel in the post-intervention period. Further work needs to be done to improve the number of these patients we reach prior to them taking their first dose of medication, as well as the number of patients we are able to counsel face-to-face.

The Role and Responsibility of Clinical Pharmacists in Rheumatology Clinic: An exploratory study in Hong Kong

In Hong Kong, arthritis is the third leading chronic disorder among the older people. It could create a huge amount of burden on the health care system if patients cannot achieve good diseases control and have recurrent flare up of diseases. To maintain stable control and minimize acute flare up, medication adherence is essential. Studies revealed that drug education has the highest evidence in improving medication adherence. Pharmacists who are expert in drugs can provide counseling to arthritis patients, improving their drug adherence and disease activities. As a result, research evaluating the effectiveness of pharmacist counseling service on improving arthritis patients’ medication adherence and disease activities in Hong Kong has been initiated in a specialist out-patient clinic of a local acute hospital. This research aims to improve patient medication adherence and enhance medication safety. A validated Compliance Questionnaire on Rheumatology (CQR-19) is used to measure the medication adherence. From the preliminary data, over 90% of the recruited subjects are non-adherence at baseline and thus, detailed drug counseling is necessary. During the first visit, pharmacists will provide a 20 minutes drug counseling service to the referred patients. This includes discussion on drug administration schedule, importance of drug adherence, side effects management and pain management. Besides, pharmacists also have different roles in other aspects such as drug information and procurement. Pharmacists would assist in providing evidence-based information and recommendations to physicians and nurses for drug-related enquiries. These attempts to improve therapeutic outcomes and minimize medication errors, enhance medication safety and reduce hospitalization. Design of the multidisciplinary care model and results of this study would provide a reference for the future development of clinical pharmacist service in rheumatology.