Effect of Pharmacy Involvement in Transitions of Care for Children With Medical Complexity

Abstract

OBJECTIVE The purpose of this study is to evaluate the effects of pharmacy integration into care transitions for children with medical complexity. These children are at a higher risk for medication errors and adverse effects because of their complex medication regimens. In addition, care transitions increase the risk for medication errors, especially during hospital-to-home transitions. METHODS This was a retrospective chart review of patients enrolled in a complex care clinic who were discharged between September 1, 2021, and December 31, 2021, and who had received a discharge medication evaluation. Intervention categories were predetermined (medication reconciliation and clinical interventions) and documented. The primary outcome was to quantify and characterize the types of interventions made by the pharmacist. Descriptive statistics were used for data analysis. Continuous data were analyzed using Wilcoxon rank sum test, and correlation was measured using Spearman correlation values. RESULTS A total of 92 clinic encounters for 60 patients were included, with a median patient age of 7 years (IQR, 5–12.3), median length of stay of 3.2 days (IQR, 1.2–5.7), and a median number of 18 discharge medications (IQR, 14.8–25). A total of 283 interventions were made, consisting of 192 (68%) clinical interventions and 91 (32%) medication reconciliation interventions. In addition, 82 (89%) of the clinic encounters had at least one pharmacist intervention. CONCLUSIONS Pharmacist evaluation of a patient’s discharge medication regimen clarifies and better optimizes the patient’s medication regimen.