Assessing intradisciplinary pharmacy communication related to transitions of care.

Background: Pharmacists play an important role in transitions of care, where successful communication is vital. The primary objective of this study was to assess the extent of intradisciplinary communication between pharmacists during patient transitions of care. Secondary objectives were to evaluate pharmacist communication practices and to explore the potential barriers and facilitators to effective health communications. Methods: A twenty item online survey was administered by email to all pharmacists practicing within a multisite regional healthcare system in central and northeastern Pennsylvania. Statistical analysis consisted of descriptive statistics for multiple choice, select all that apply, and Likert-type questions. Themes were summarized for open ended questions. Results: A total of 132 (32%) pharmacists responded to the survey of which 90 responses were included in the analysis. The majority of pharmacists felt either extremely comfortable (53.3%) or somewhat comfortable (33.3%) reaching out to another pharmacist within the same health system. However, most contacted other pharmacy disciplines within the health system ≤25% of their work week. The ability to reach the pharmacist was the most important factor to pharmacist comfort (extremely important n = 56, somewhat important n = 27). Not knowing who to contact was the biggest barrier (44.8%). The electronic messaging systems Microsoft Teams (almost always n = 33, often n = 25) and TigerText (almost always n = 17, often n = 23) were the forms of communication utilized most often. Conclusions: Pharmacists feel comfortable communicating with pharmacists across different entities within the health system, however, intradisciplinary communication related to transitions of care activities is limited. Improving awareness of system-wide pharmacist directories (34.2%) and distribution of pharmacist schedules (18.4%) were identified as tools that may improve communication.

Perceptions of near-peer teaching in a pharmacy skills-based laboratory.

OBJECTIVE: To assess the perception of students, faculty, and previous lab coaches on a near-peer teaching model integrated into a skills-based laboratory. METHODS: As part of a longitudinal near-peer teaching experience, third professional year students are utilized as lab coaches in a skills-based laboratory course. Lab coaches deliver lectures, provide feedback, facilitate activities, and assist with class preparation spanning 2 semesters for first and second professional year students. Students enrolled in the courses received an anonymous 12-question survey to assess the comfort and helpfulness of feedback when working with a lab coach and faculty during the 2021-2022 academic year. Statistical analysis was conducted using descriptive and inferential statistics for survey questions, and thematic analysis for open-ended responses. Semi-structured interviews with previous lab coaches and faculty were conducted, and thematic analysis was utilized for the responses. RESULTS: The student survey had an 81.4% response rate (n = 114). Students were significantly more comfortable working with and asking questions to a lab coach than a faculty instructor (mean [SD] of 4.78 [0.66] vs 4.44 [0.75]). Nine (75%) previous lab coaches and 6 (43%) faculty members were also interviewed. A total of 6 themes regarding perceptions of the lab coach position emerged: positive impact on personal and professional development; relationship building; rewarding experience recommended to others; robust teaching experience; struggles and challenges faced by both faculty and lab coaches; appreciation of the position by faculty. CONCLUSION: Implementing near-peer teachers into a pharmacy skills-based laboratory was very well received by students, previous lab coaches, and faculty.

Impact of interdisciplinary case management and pharmacist transitions of care interventions on 30-day readmissions.

BACKGROUND: Pharmacists and case managers positively impact patient health outcomes during the transition of care from the hospital to the home. However, the combination of both specialties completing post-discharge telephone calls has not been clearly studied. OBJECTIVES: The primary outcome of this research was to identify the combined impact of post-discharge telephone calls from both pharmacists and case managers on all cause 30-day hospital readmissions when compared to a call from either group alone. Secondary outcomes included 30-day emergency department visits and types of medication therapy problems identified by pharmacists during the call. METHODS: This retrospective study included high risk patients eligible for a post-discharge telephone call from both pharmacy and case management from January 1, 2021 to September 1, 2021. Patients were excluded if they did not complete a telephone call from either group or were deceased within 30 days of discharge. Results were analyzed using descriptive and chi square analyses. RESULTS: Eighty-five hospital discharges were included in the study, with 24 patients receiving post-discharge telephone calls from both case management and pharmacy, and 61 patients receiving a call from either group alone. Thirty-day all cause readmissions occurred in 13% of the combined group versus 26% in either group alone (p = 0.171). Thirty-day all cause emergency department visits were 8% in the combined group versus 11% in either group alone (p = 0.617). Of the 38 post-discharge encounters completed by pharmacists, 120 medication therapy problems were identified, averaging over 3 medication issues per patient. CONCLUSIONS: Collaboration amongst pharmacists and case managers has the potential to positively impact patient outcomes upon discharge from the hospital. Health systems should work to integrate transitions of care services performed across disciplines.

Naloxone coprescription in U.S. ambulatory care centers and emergency departments.

OBJECTIVES: The rise in both drug overdoses and deaths owing to opioids has been increasing for at least 2 decades in the United States. Naloxone-prescribing programs have been in use since the mid-2000s with a guideline to manage their use being published in 2012. This study seeks to determine the national prevalence of naloxone coprescribing within U.S. ambulatory care centers and emergency departments (EDs). METHODS: This study was a retrospective, cross-sectional, observational analysis of data collected by the Centers for Disease Control and Prevention (CDC) in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey: Emergency Department Summary during the years 2012-2016. All survey participants aged 18 years or older with documented opioid use-with the exception of codeine, dihydrocodeine, and opioid-containing cough syrups-were included. Variables of interest that were available in the data were summarized. RESULTS: Naloxone was coprescribed with opioids in less than 0.1% of visits. Despite 5 years of data combined across 2 national surveys including 48,158 adults with documented opioid use, further analyses of naloxone coprescription could not be performed owing to the limited number of such coprescriptions. Among the factors previously documented to increase the risk of opioid overdose, concurrent benzodiazepine use (18.7%) was the most reported, followed by history of substance use disorder (1.6%) and history of overdose (< 0.1%). CONCLUSION: Using nationally representative data collected by the CDC from ambulatory care centers and EDs, we found that naloxone was coprescribed with opioids in only less than 0.1% of visits. Future research is warranted to determine whether current practices have adapted to meet the standards set by the 2016 CDC guidelines.