INNOVATIONS in pharmacy

Characteristics of Patients Accepting and Declining Participation in a Transition of Care Service Provided by a Community Pharmacy

Julianne M Kowalski, PharmD

University of Arizona, College of Pharmacy – Tucson, AZ

Amanda R Margolis, PharmD, MS

University of Wisconsin, School of Pharmacy – Madison, WI

Nicole Schreiner, PharmD

Streu’s Pharmacy Bay Natural – Green Bay, WI

Jeff Kirchner, RPh

Streu’s Pharmacy Bay Natural – Green Bay, WI

DOI: https://doi.org/10.24926/iip.v8i1.496

Keywords: Patients, Perceptions, Community, Pharmacy, Pharmacists, Health Belief Model, Transitions of Care, Pharmacy Services

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Abstract

Objectives: To identify characteristics of patients who accepted or declined an appointment for a transition of care service provided by an independent community pharmacist and identify the most common reasons patients declined the service.

Methods: A transition of care service was offered by a community pharmacy to patients discharged to home from the cardiac unit of a local hospital. The community pharmacist approached patients prior to discharge for recruitment into the service. Outcomes included service acceptance rate, LACE score at discharge, readmission risk category, age, gender, geographic home location, and reason for refusing the service. Descriptive statistics and logistic regression were used to compare characteristics between those who accepted or declined the service. Reasons for decline were assessed using content analysis.

Results: Of the 87 patients that were included in the analysis, 21 patients received the transitions of care service (24.1%). None of the characteristics were found to be statistically significant between patients who received or declined the service. Patients at a moderate risk for readmission seemed more likely to accept the pharmacist-run appointment than those at high risk (27.9% vs 15.3%; P = 0.29). Of the 66 patients who declined, 51 gave a reason (77.3%). Thirty-nine patients saw no benefit (76.5%), five patients had perceived barriers (10%), and seven patients gave reasons that fell into both categories (13.5%).

Conclusions: This evaluation did not find a statistically significant difference in characteristics between those patients who accepted or declined participation in a pharmacist-run transition of care service. Patients may be less likely to accept pharmacist-run transition of care appointments primarily due to no perceived benefits. To increase participation, we need to understand the patient’s health beliefs, educate patients on pharmacy services, and implement changes to recruit potential patients.

Conflict of Interest

Disclosures: The authors have no actual or potential conflict of interest in relation to this evaluation.

This evaluation was presented as a poster presentation at American Pharmacists Association Annual Meeting and Exposition, March 4-7, 2016 and at the Pharmacy Society of Wisconsin Education Conference, April 5-6, 2016. This evaluation was presented as a podium presentation at Great Lakes Residency Conference, April 27-29, 2016.

 

Type: Original Research