Pharmacists in primary care settings have unique opportunities to address the causes\nof ineffective care transitions. The objective of this study is to describe the implementation of a\nmultifaceted pharmacist transitions of care (TOC) intervention integrated into a primary care practice\nand evaluate the effectiveness of the program. This was a two-phase pilot study describing the\ndevelopment, testing, and evaluation of the TOC program. In Phase 1, the TOC intervention was\nimplemented in a general patient population, while Phase 2 focused the intervention on high-risk\npatients. The two pilot phases were compared to each other (Phase 1 vs. Phase 2) and to a historical\ncontrol group of patients who received usual care prior to the intervention (Phase 1 and Phase 2\nvs. control). The study included 138 patients in the intervention group (Phase 1: 101 and Phase 2:\n37) and 118 controls. At baseline, controls had a significantly lower LACE index, shorter length of\nstay, and a lower number of medications at discharge, indicating less medical complexity. A total of\n344 recommendations were provided over both phases, approximately 80% of which were accepted.\nIn adjusted models, there were no significant differences in 30-day all-cause readmissions between\nPhase 2 and controls (aOR 0.78; 95% CI 0.21â??2.89; p = 0.71) or Phase 1 (aOR 0.99; 95% CI 0.30â??3.37; p\n= 0.99). This study successfully implemented a pharmacist-led TOC intervention within a primary\ncare setting using a two-phase pilot design. More robust studies are needed in order to identify TOC\ninterventions that reduce healthcare utilization in a cost-effective manner.
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