Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Medication related problems (MRPs) are common after hospitalization. Coupled with inadequate follow-up post-discharge, it can lead to downstream rehospitalizations and higher healthcare costs. Transitions of care (ToC) introduce a variety of patient challenges, ranging from new medications and changes to existing regimen. The MIH-CP program affiliated with the University of Maryland Medical Center (UMMC) focuses on improving patient transitions by addressing both medical and social determinants of health.
Research Question or Hypothesis: To quantify and evaluate MIH-CP pharmacist identified MRPs during ToC visits during July 1, 2021-July 31, 2022.
Study Design: A retrospective observational study. Adult patients discharged from UMMC or UMMC Midtown campus, and residing in West Baltimore zip codes were enrolled in MIH-CP program.
Methods: A descriptive analysis of the MRP, the types and the severity and the potential medication-related harm. For each MRP, the pharmacist documented the category, medication name, actions taken to resolve, and the outcome of the intervention in a Microsoft Excel database. A thorough evaluation of the pharmacists’ documentation was conducted and utilized as the main data source for this study.
Results: 334 ToC visits were conducted during the 1-year study period. 80.4% of patients had at least one MRP. A total of 545 MRPs were identified and intervened on by the pharmacist during the study period. Of the 545 MRPs, 458 were classified by severity- 39% mild, 23.5% moderate, and 20.5% severe. Nearly half (46%) of the total MRPs were classified as missing medications. The severity status was determined by the potential of the MRP to lead to a hospital readmission. In the severe category, 53.6% were correlated with cardiovascular medications, 19.5% were respiratory agents and 14.3% were antidiabetic agents.
Conclusion: Pharmacists play an integral role in preventing MRPs, especially where high-risk patients and health literacy concerns are a conflict.
Presenting Author
Olufunke Sokan PharmD, MPharm, BCACPUniversity of Maryland School of Pharmacy
Authors