Yannick Villeneuve1, Fanny Courtemanche2, Faranak Firoozi3, Suzanne Gilbert4, Marie-Pier Desbiens5, Audrey Desjardins6, Christine Dinh7, Véronique C LeBlanc8, Audrey Attia9. 1. Department of Pharmacy, Institut Universitaire de Gériatrie de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565 Queen Mary Rd, Montreal, Quebec, H3W 1W5, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary Rd, Montreal, Quebec, H3W 1W6, Canada. Electronic address: yannick.villeneuve.ccsmtl@ssss.gouv.qc.ca. 2. Department of Pharmacy, Institut Universitaire de Gériatrie de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565 Queen Mary Rd, Montreal, Quebec, H3W 1W5, Canada. Electronic address: fanny.courtemanche.ccsmtl@ssss.gouv.qc.ca. 3. Department of Pharmacy, Institut Universitaire de Gériatrie de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565 Queen Mary Rd, Montreal, Quebec, H3W 1W5, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary Rd, Montreal, Quebec, H3W 1W6, Canada. Electronic address: faranak.firoozi.ccsmtl@ssss.gouv.qc.ca. 4. Department of Pharmacy, Institut Universitaire de Gériatrie de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565 Queen Mary Rd, Montreal, Quebec, H3W 1W5, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary Rd, Montreal, Quebec, H3W 1W6, Canada. Electronic address: suzanne.gilbert.ccsmtl@ssss.gouv.qc.ca. 5. Faculty of Pharmacy, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, Canada; Department of Pharmacy, Jewish General Hospital, 3755 Côte-Sainte-Catherine Rd, Montreal, Quebec, Canada. Electronic address: marie-pier.desbiens@umontreal.ca. 6. Faculty of Pharmacy, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, Canada; Department of Pharmacy, Jewish General Hospital, 3755 Côte-Sainte-Catherine Rd, Montreal, Quebec, Canada. Electronic address: audrey.desjardins.3@umontreal.ca. 7. Faculty of Pharmacy, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, Canada; Department of Pharmacy, Jewish General Hospital, 3755 Côte-Sainte-Catherine Rd, Montreal, Quebec, Canada. Electronic address: christine.dinh@umontreal.ca. 8. Faculty of Pharmacy, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, Canada; Department of Pharmacy, Jewish General Hospital, 3755 Côte-Sainte-Catherine Rd, Montreal, Quebec, Canada. Electronic address: veronique.leblanc.6@umontreal.ca. 9. Geriatrics and Gerontology Library, Institut Universitaire de Gériatrie de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565 Queen Mary Rd, Montreal, Quebec, H3W 1W5, Canada. Electronic address: audrey.attia.ccsmtl@ssss.gouv.qc.ca.
Abstract
BACKGROUND: Current literature has shown increasing risk of error in transition of care between different healthcare settings, especially in the older population. Moreover, drug-related hospital readmission has been reported due to lack of appropriate communication. However, the literature is not clear about the impact of pharmacist interventions during transition of care of older adults on the reduction in use of healthcare services. OBJECTIVE: The goal of the scoping review was to describe the impact of pharmacist interventions during transitions of care for older adults on the use of healthcare services. METHODS: MEDLINE was searched for randomized controlled trials and controlled studies that analyzed pharmacist interventions during transition of care of older adults with regard to use of healthcare services. Four reviewers, grouped in pairs, independently screened all references published from 1990 to 2019 and extracted and analyzed the data. A pharmaceutical model of 8 pharmacist-led interventions was adapted from literature to compare the included studies. RESULTS: There were 1527 publications screened, 17 of which met inclusion criteria. Pharmacist-led interventions decreased the use of healthcare services in 11 of these studies. The majority of studies were of very good or good quality based on Mixed Methods Appraisal Tool. Pharmacist were implicated at all times during the transition of care process (i.e. admission/during stay, discharge and post-discharge) in 4 of the effective studies, whereas none did in the not effective studies. More interventions were accomplished by pharmacists in studies with positive outcomes. CONCLUSION: By diversifying their interventions at different moments throughout transition of care, pharmacists can reduce the use of healthcare services for older adults during transition of care. This scoping review also shows the need to better understand key components of post-discharge interventions and to have a dynamic pharmaceutical model accepted by the scientific community.
BACKGROUND: Current literature has shown increasing risk of error in transition of care between different healthcare settings, especially in the older population. Moreover, drug-related hospital readmission has been reported due to lack of appropriate communication. However, the literature is not clear about the impact of pharmacist interventions during transition of care of older adults on the reduction in use of healthcare services. OBJECTIVE: The goal of the scoping review was to describe the impact of pharmacist interventions during transitions of care for older adults on the use of healthcare services. METHODS: MEDLINE was searched for randomized controlled trials and controlled studies that analyzed pharmacist interventions during transition of care of older adults with regard to use of healthcare services. Four reviewers, grouped in pairs, independently screened all references published from 1990 to 2019 and extracted and analyzed the data. A pharmaceutical model of 8 pharmacist-led interventions was adapted from literature to compare the included studies. RESULTS: There were 1527 publications screened, 17 of which met inclusion criteria. Pharmacist-led interventions decreased the use of healthcare services in 11 of these studies. The majority of studies were of very good or good quality based on Mixed Methods Appraisal Tool. Pharmacist were implicated at all times during the transition of care process (i.e. admission/during stay, discharge and post-discharge) in 4 of the effective studies, whereas none did in the not effective studies. More interventions were accomplished by pharmacists in studies with positive outcomes. CONCLUSION: By diversifying their interventions at different moments throughout transition of care, pharmacists can reduce the use of healthcare services for older adults during transition of care. This scoping review also shows the need to better understand key components of post-discharge interventions and to have a dynamic pharmaceutical model accepted by the scientific community.