Original Research
Monday, November 13, 2023
01:00 PM–02:30 PM
Abstract
Introduction: Student pharmacists improve readmission rates through the TOC process, but their interventions have not been detailed.
Research Question or Hypothesis: The study summarized interventions and social determinants of health (SDOH) barriers identified by pharmacy students in a TOC service.
Study Design: This was a retrospective chart review of 315 TOC patients between January 2019 and October 2022 from an urban medical residency clinic.
Methods: Pharmacy students followed and met with clinic patients who were admitted to an inpatient service. The meetings included discussions regarding their medications and identification of their conceived barriers and concerns. Information gathered within these meetings was documented in a discharge handoff which included any interventions or follow up needed. Interventions in the handoff were coded into one of three categories: drug therapy, SDOH, or other. The handoff was documented in the patient’s chart. The interventions were addressed post discharge by the ambulatory care pharmacist, PCP, or social worker.
Results: Of the 315 admissions reviewed, patients were primarily female (53.62%), white (56.19%), and average age 60 years old (IQR [49-69]). Pharmacy students identified 256 interventions over the 315 total admissions reviewed. The number of interventions per patient ranged from zero (n=193, 61.27%) to five (n=3, 0.95%). The interventions were evenly distributed between the three categories: 32.81% (n=84) drug interventions, 29.69% (n=76) SDOH, and 37.50% (n=96) other concerns. The most common drug intervention was adherence (n=42, 50.00%). SDOH interventions were most commonly tobacco use (n=19, 25.35%) and transportation (n=17, 22.37%), and the most frequent other concerns were need for medication counseling (n=42, 43.75%) and optimization of therapy (n=29, 30.21%).
Conclusion: Student pharmacists successfully identify a variety of interventions during the TOC process. Barriers and interventions were highly variable. Some of the interventions were resolved by pharmacy team improved while others relied on interdisciplinary team members.
Presenting Author
Shelby Kelsh Pharm DFerris State University College of Pharmacy
Authors
Hanna Bronz PharmD Candidate 2025
Ferris State University College of Pharmacy
Margaret de Voest PharmD
Ferris State University