Abstract:
:During the past decade, patient safety issues during care transitions have gained greater attention at both the local and national level. Readmission rates to U.S. hospitals are high, often because of poor care transitions. Serious adverse drug events (ADEs) caused by an incomplete understanding of changes in complex drug regimens can be an important factor contributing to readmission rates. This paper describes the roles and responsibilities of pharmacists in ensuring optimal outcomes from drug therapy during care transitions. Barriers to effective care transitions, including inadequate communication, poor care coordination, and the lack of one clinician ultimately responsible for these transitions, are discussed. This paper also identifies specific patient populations at high risk of ADEs during care transitions. Several national initiatives and newer care transition models are discussed, including multi- and interdisciplinary programs with pharmacists as key members. Among their potential roles, pharmacists should participate on medical rounds where available, perform medication reconciliation and admission drug histories, apply their knowledge of drug therapy to anticipate and resolve problems during transitions, communicate changes in drug regimens between providers and care settings, assess the appropriateness and patient understanding of drug regimens, promote adherence, and assess health literacy. In addition, this paper identifies barriers and ongoing challenges limiting greater involvement of pharmacists from different practice settings during care transitions. Professional degree programs and residency training programs should increase their emphasis on pharmacists' roles, especially as part of interdisciplinary teams, in improving patient safety during care transitions in diverse practice settings. This paper also recommends that Accreditation Council for Pharmacy Education (ACPE) standards include specific language regarding the exposure of students to issues regarding care transitions and that students have several opportunities to practice the skills needed for effective care transitions. Moreover, reimbursement mechanisms that permit greater pharmacist involvement in providing medication assistance to patients going through care transitions should be explored. Although health information technology offers the potential for safer care transitions, pharmacists' use of information technology must be integrated into the national initiatives for pharmacists to be effectively involved in care transitions. This paper concludes with a discussion about the importance of recognizing and addressing health literacy issues to promote patient empowerment during and after care transitions.
journal_name
Pharmacotherapyjournal_title
Pharmacotherapyauthors
American College of Clinical Pharmacy.,Hume AL,Kirwin J,Bieber HL,Couchenour RL,Hall DL,Kennedy AK,LaPointe NM,Burkhardt CD,Schilli K,Seaton T,Trujillo J,Wiggins Bdoi
10.1002/phar.1215subject
Has Abstractpub_date
2012-11-01 00:00:00pages
e326-37issue
11eissn
0277-0008issn
1875-9114journal_volume
32pub_type
杂志文章相关文献
PHARMACOTHERAPY文献大全abstract::Two analyses were conducted to compare the cost-effectiveness of different intravenous immunoglobulin (IGIV) formulations: IGIV purified by caprylate precipitation and chromatography (IGIV-C) and IGIV manufactured by an older solvent-detergent method (IGIV-S/D). The results indicated that IGIV-C is associated with cos...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.2005.25.11part2.94S
更新日期:2005-11-01 00:00:00
abstract::Venous thromboembolism (VTE) is an important medical problem that affects millions of patients each year. With appropriate prophylaxis, many of these thromboembolic events can be prevented. Although strong evidence supporting VTE prophylaxis spans several decades, several large American and global registries have docu...
journal_title:Pharmacotherapy
pub_type:
doi:10.1592/phco.29.4.410
更新日期:2009-04-01 00:00:00
abstract::A 71-year-old Caucasian woman was admitted to the hospital with right-sided weakness and slurred speech. Glioblastoma multiforme was diagnosed, and resection of the tumor was performed. During the patient's hospitalization, blood and urine cultures were obtained after her temperature rose to 103.3 degrees F. Four bloo...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.27.1.161
更新日期:2007-01-01 00:00:00
abstract::Abstract Cetuximab and panitumumab, monoclonal antibodies used to target the epidermal growth factor receptor (EGFR), were recently approved by the United States Food and Drug Administration for use as single agents or in combination with other chemotherapy drugs in the treatment of metastatic colorectal cancer. The a...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.28.11-supp.31S
更新日期:2008-11-01 00:00:00
abstract::Recent attention has been called to the interpretation of studies of antiinfective agents demonstrating effects on the QTc interval. It seems that the effects of many of these agents on the QTc interval are small, but in some patient populations, these drugs may cause morbidity and mortality related to TdP. It would b...
journal_title:Pharmacotherapy
pub_type: 评论,杂志文章
doi:10.1592/phco.22.8.663.33201
更新日期:2002-05-01 00:00:00
abstract::Intravenous immunoglobulins are biologic substances and differ in many respects from chemical pharmaceuticals. To produce a safe and efficacious preparation, special points must be considered. Careful screening procedures and excluding high-risk donor populations reduce the risk of transmitting viral disease from the ...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/j.1875-9114.1987.tb03512.x
更新日期:1987-01-01 00:00:00
abstract::Torsade de pointes is a rare but potentially fatal ventricular arrhythmia that is often triggered by drugs that prolong the rate-corrected QT (QTc) interval. This arrhythmia has been attributed to levacetylmethadol and methadone, synthetic opioids used to treat heroin addiction. Levacetylmethadol, a derivative of meth...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.25.4.611.61020
更新日期:2005-04-01 00:00:00
abstract::We evaluated the efficacy and tolerability of amphotericin B triglyceride emulsion in 16 patients with acquired immunodeficiency syndrome-related candidal esophagitis and cryptococcosis, compared with standard amphotericin B in 24 patients. Compared with the conventional formulation, the fat emulsion was administered ...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::Aztreonam is the first monobactam available for use in this country. A parenteral antibiotic, its antibacterial spectrum is limited to gram-negative aerobic pathogens. The drug's pharmacologic, pharmacokinetic, and toxicologic properties are reviewed. Based on early experience in pediatric patients, certain recommenda...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract:STUDY OBJECTIVES:To compare the effectiveness of bivalirudin and argatroban in achieving anticoagulation goals and to compare clinical outcomes assessing the safety and efficacy in patients with known or suspected heparin-induced thrombocytopenia (HIT). DESIGN:Single-center, retrospective analysis. SETTING:Large tert...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.30.12.1229
更新日期:2010-12-01 00:00:00
abstract::The incidence and severity of Clostridium difficile infection (CDI) remain high across intensive care units in the United States despite national efforts to decrease this escalating health care burden. Most published literature and guidelines address treatment rather than prevention, yet this approach may be too downs...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.2200
更新日期:2019-03-01 00:00:00
abstract::Conditions in which antidepressants have been used include diabetic neuropathy, postherpetic neuralgia, headaches, arthritis, chronic back pain, cancer, thalamic pain, facial pain, and phantom limb pain. Although much of the available information is derived from inadequately controlled trials, it seems that antidepres...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::Warfarin, a vitamin K antagonist, has been the only orally available anticoagulant for > 60 years. During the past decade, the U.S. Food and Drug Administration has approved several target-specific oral anticoagulants (TSOACs) for the prophylaxis and treatment of arterial and venous thromboembolism and stroke preventi...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1532
更新日期:2015-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the impact of having an antimicrobial allergy label in the medical record on clinical outcomes in hospitalized patients. DESIGN:Retrospective cohort study. SETTING:Urban academic teaching hospital. PATIENTS:A total of 11,872 adults admitted to nonsurgical patient care wards who received ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.31.8.742
更新日期:2011-08-01 00:00:00
abstract::Genotype-guided warfarin dosing algorithms are a rational approach to optimize warfarin dosing and potentially reduce adverse drug events. Diverse populations, such as African Americans and Latinos, have greater variability in warfarin dose requirements and are at greater risk for experiencing warfarin-related adverse...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1982
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To compare changes in United States pharmacy practice faculty demographics from 1995-2001 and to discuss the implications for junior faculty development. METHODS:Demographic data were extracted from the American Association of Colleges of Pharmacy institutional research system for academic years 1995-1996 an...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.22.7.445.33678
更新日期:2002-04-01 00:00:00
abstract::Verapamil hydrochloride, a prototype calcium antagonist, is now marketed in the United States for the acute treatment of supraventricular tachyarrhythmias and for chronic management of vasospastic and chronic stable angina. It inhibits the slow inward channel in in the heart and blocks calcium influx in smooth muscle....
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/j.1875-9114.1982.tb03210.x
更新日期:1982-11-01 00:00:00
abstract::Panic disorder is a frequently chronic condition with extensive patterns of psychiatric comorbidity. Optimum pharmacotherapy with traditional agents is limited by side effects, long-term tolerability, and other problems. Recent research findings support the characterization of panic disorder as an illness involving de...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1997-03-01 00:00:00
abstract::Cefepime is a new extended-spectrum cephalosporin with gram-positive and gram-negative coverage including Staphylococcus aureus and Pseudomonas aeruginosa. We evaluated the drug's plasma, peritoneal fluid, and appendix tissue concentrations in patients with a postoperative diagnosis of perforated or gangrenous appendi...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1991-01-01 00:00:00
abstract::Methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia is associated with high morbidity and mortality. Traditionally, antistaphylococcal penicillins (ASPs) have been considered the agents of choice for the treatment of MSSA bacteremia. Vancomycin has been demonstrated to have poorer outcomes in several studi...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1892
更新日期:2017-03-01 00:00:00
abstract::Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. A 73-year-old man presented with AIS. H...
journal_title:Pharmacotherapy
pub_type:
doi:10.1002/phar.1997
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:There is a high prevalence of HIV infection in Newark, New Jersey, with University Hospital admitting approximately 600 HIV-infected patients per year. Medication errors involving antiretroviral therapy (ART) could significantly affect treatment outcomes. The goal of this study was to evaluate the effectiven...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1716
更新日期:2016-03-01 00:00:00
abstract:STUDY OBJECTIVE:To determine prescribing patterns and clinical outcomes of enoxaparin for anticoagulation of atrial fibrillation. DESIGN:Retrospective analysis. SETTING:A 650-bed, tertiary care, community teaching hospital. SUBJECTS:Two hundred thirteen patients who received enoxaparin for thromboprophylaxis during ...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章
doi:10.1592/phco.23.5.651.32208
更新日期:2003-05-01 00:00:00
abstract::Drug-induced neutropenia and agranulocytosis are rare adverse events but can be fatal. Neutropenia can be induced by a myriad of drugs from almost every pharmacologic class. Octreotide is a somatostatin analog that has been used to treat variceal bleeding, acromegaly, and severe diarrhea associated with metastatic tum...
journal_title:Pharmacotherapy
pub_type:
doi:10.1002/phar.1942
更新日期:2017-06-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the effect of a standard meal on bioavailability of bromfenac, and on the relative analgesic efficacy and adverse effect liability of bromfenac 25 mg, naproxen sodium 550 mg, and acetaminophen 325 mg in the treatment of pain after orthopedic surgery. DESIGN:Randomized, double-blind, single...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-05-01 00:00:00
abstract::The Internet is an excellent source of drug and poison information. Despite the relative case and minimal costs associated with accessing the Internet, many pharmacists and other health care professionals have been slow to adopt this new technology. ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:Assess the effects of linezolid on hematologic outcomes in newly diagnosed patients with acute myeloid leukemia (AML) following induction chemotherapy. DESIGN:Single-center, retrospective, observational, cohort study. SETTING:Large, tertiary care academic medical center. PATIENTS:A total of 225 patients ≥ ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1824
更新日期:2016-10-01 00:00:00
abstract::Acute graft-versus-host disease (GVHD) remains the major obstacle for successful allogeneic bone marrow transplantation (BMT). The frequency of grade II or higher acute GVHD ranges from 30-50% in human leukocyte antigen (HLA)-matched sibling transplants and 50-80% in HLA-matched unrelated transplants. The mortality an...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 00:00:00
abstract::A 12-year-old girl with cystic fibrosis was diagnosed with a high-grade glioma after radiographic and biopsy results confirmed the primary intracranial lesion. She was treated with single-agent erlotinib during and after daily localized radiation therapy. Pharmacokinetic studies were conducted to assess the effect of ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.29.7.858
更新日期:2009-07-01 00:00:00
abstract::Methicillin-resistant Staphylococcus aureus (MRSA) has become the most prevalent cause of acute hematogenous osteomyelitis (AHO) in pediatric patients. This increase in MRSA is due to the rise in community-acquired MRSA. Therefore, it is important that clinicians are aware of the various and upcoming therapies that co...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.2164
更新日期:2018-10-01 00:00:00