Impact of discharge medication counseling in the cardiology unit of a tertiary hospital in Brazil: A randomized controlled trial

Bonetti, AF; Bagatim, BQ; Mendes, AM; Rotta, I; Reis, RC; Fávero, MLD; Fernandez-Llimós, F; Pontarolo, R

Impact of discharge medication counseling in the cardiology unit of a tertiary hospital in Brazil: A randomized controlled trial

Bonetti, AF Bagatim, BQ Mendes, AM Rotta, I Reis, RC Fávero, MLD Fernandez-Llimós, F

Pontarolo, R

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Publication Type:: Journal Article
Citation:: Clinics, 2018, 73
Issue Date:: 2018-01-01

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Field	Value	Language
dc.contributor.author	Bonetti, AF	en_US
dc.contributor.author	Bagatim, BQ	en_US
dc.contributor.author	Mendes, AM	en_US
dc.contributor.author	Rotta, I	en_US
dc.contributor.author	Reis, RC	en_US
dc.contributor.author	Fávero, MLD	en_US
dc.contributor.author	Fernandez-Llimós, F https://orcid.org/0000-0002-8529-9595	en_US
dc.contributor.author	Pontarolo, R	en_US
dc.date.available	2017-11-08	en_US
dc.date.issued	2018-01-01	en_US
dc.identifier.citation	Clinics, 2018, 73	en_US
dc.identifier.issn	1807-5932	en_US
dc.identifier.uri	http://hdl.handle.net/10453/131544
dc.description.abstract	© 2018 CLINICS. OBJECTIVES: This study aimed to evaluate the impact of pharmacist-provided discharge counseling on mortality rate, hospital readmissions, emergency department visits, and medication adherence at 30 days post discharge. METHODS: This randomized controlled trial was approved by the local ethics committee and included patients aged 18 years or older admitted to the cardiology ward of a Brazilian tertiary hospital. The intervention group received a pharmacist-led medication counseling session at discharge and a telephone follow-up three and 15 days after discharge. The outcomes included the number of deaths, hospital readmissions, emergency department visits, and medication adherence. All outcomes were evaluated during a pharmacist-led ambulatory consultation performed 30 days after discharge. RESULTS: Of 133 patients, 104 were included in the analysis (51 and 53 in the intervention and control groups, respectively). The intervention group had a lower overall readmission rate, number of emergency department visits, and mortality rate, but the differences were not statistically significant (p>0.05). However, the intervention group had a significantly lower readmission rate related to heart disease (0% vs. 11.3%, p=0.027), despite the small sample size. Furthermore, medication counseling contributed significantly to improved medication adherence according to three different tools (p<0.05). CONCLUSIONS: Pharmacist-provided discharge medication counseling resulted in better medication adherence scores and a lower incidence of cardiovascular-associated hospital readmissions, thus representing a useful service for cardiology patients.	en_US
dc.relation.ispartof	Clinics	en_US
dc.relation.isbasedon	10.6061/clinics/2018/e325	en_US
dc.subject.classification	General Clinical Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Heart Diseases	en_US
dc.subject.mesh	Patient Discharge	en_US
dc.subject.mesh	Patient Readmission	en_US
dc.subject.mesh	Professional Role	en_US
dc.subject.mesh	Directive Counseling	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Pharmacists	en_US
dc.subject.mesh	Cardiology Service, Hospital	en_US
dc.subject.mesh	Brazil	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Medication Adherence	en_US
dc.subject.mesh	Tertiary Care Centers	en_US
dc.title	Impact of discharge medication counseling in the cardiology unit of a tertiary hospital in Brazil: A randomized controlled trial	en_US
dc.type	Journal Article
utslib.citation.volume	73	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	open_access
pubs.publication-status	Published	en_US
pubs.volume	73	en_US

Abstract:

© 2018 CLINICS. OBJECTIVES: This study aimed to evaluate the impact of pharmacist-provided discharge counseling on mortality rate, hospital readmissions, emergency department visits, and medication adherence at 30 days post discharge. METHODS: This randomized controlled trial was approved by the local ethics committee and included patients aged 18 years or older admitted to the cardiology ward of a Brazilian tertiary hospital. The intervention group received a pharmacist-led medication counseling session at discharge and a telephone follow-up three and 15 days after discharge. The outcomes included the number of deaths, hospital readmissions, emergency department visits, and medication adherence. All outcomes were evaluated during a pharmacist-led ambulatory consultation performed 30 days after discharge. RESULTS: Of 133 patients, 104 were included in the analysis (51 and 53 in the intervention and control groups, respectively). The intervention group had a lower overall readmission rate, number of emergency department visits, and mortality rate, but the differences were not statistically significant (p>0.05). However, the intervention group had a significantly lower readmission rate related to heart disease (0% vs. 11.3%, p=0.027), despite the small sample size. Furthermore, medication counseling contributed significantly to improved medication adherence according to three different tools (p<0.05). CONCLUSIONS: Pharmacist-provided discharge medication counseling resulted in better medication adherence scores and a lower incidence of cardiovascular-associated hospital readmissions, thus representing a useful service for cardiology patients.

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http://hdl.handle.net/10453/131544