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747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program

BACKGROUND: Hospitalized patients who require Infectious Diseases (ID) consultative services and are discharged on antimicrobials (AM) are medically complex and at high risk of readmission. Complications related to AM toxicity, suboptimal regimen completion, or lack of AM access are prevalent. Our I...

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Autores principales: Walston, Bobbi Jo, Fletcher, Lisa A, Wilson, William, Boerneke, Renae A, Marx, Ashley H, Vargas, John D, Farel, Claire E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810949/
http://dx.doi.org/10.1093/ofid/ofz360.815
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author Walston, Bobbi Jo
Fletcher, Lisa A
Wilson, William
Boerneke, Renae A
Marx, Ashley H
Vargas, John D
Farel, Claire E
author_facet Walston, Bobbi Jo
Fletcher, Lisa A
Wilson, William
Boerneke, Renae A
Marx, Ashley H
Vargas, John D
Farel, Claire E
author_sort Walston, Bobbi Jo
collection PubMed
description BACKGROUND: Hospitalized patients who require Infectious Diseases (ID) consultative services and are discharged on antimicrobials (AM) are medically complex and at high risk of readmission. Complications related to AM toxicity, suboptimal regimen completion, or lack of AM access are prevalent. Our ID clinic pharmacist contacted patients affiliated with ID services within 72 hours of discharge to identify and intervene on needs such as AM access and management, toxicity monitoring, AM administration teaching, and to assess discharge care progression. The goal of this intervention was to leverage the subject matter expertise of an ID-trained pharmacist to create a protocolized intervention to improve the inpatient-to-outpatient transition for ID patients. METHODS: During a 12 week time period, 173 patients were identified and enrolled in the ID DOOR intervention. Patients who received consultative care by an ID physician were tracked and automatically referred to ID DOOR; those discharged on antimicrobials were included in the intervention group. Phone-based assessment of discharge AM access, education, and administration was initiated by the ID pharmacist within 72 hours of discharge (Table 1). RESULTS: Of the 173 patients, 155 (90%) were successfully contacted post-discharge. The majority of needs identified were AM education, access, and coordination of care (Table 2). In addition, discrepancies between discharge orders, summary content, and patient instructions were prevalent. Based on the medication-related assessment performed by the ID-trained pharmacists, they were able to resolve AM-related issues and identify, triage, and link patients to appropriate multidisciplinary providers to coordinate care plans. CONCLUSION: The data highlight the prevalence of immediate post-discharge needs related to antimicrobial for patients and the critical role of ID-trained pharmacists in addressing these needs. In a large public academic medical center with uninsured and underinsured patients, additional support for AM access, education, and navigation of care plans is needed. For medically and socially complex ID patients, an ID-trained pharmacist plays a critical role in reducing risk inherent in the transition from inpatient to outpatient care. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-68109492019-10-28 747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program Walston, Bobbi Jo Fletcher, Lisa A Wilson, William Boerneke, Renae A Marx, Ashley H Vargas, John D Farel, Claire E Open Forum Infect Dis Abstracts BACKGROUND: Hospitalized patients who require Infectious Diseases (ID) consultative services and are discharged on antimicrobials (AM) are medically complex and at high risk of readmission. Complications related to AM toxicity, suboptimal regimen completion, or lack of AM access are prevalent. Our ID clinic pharmacist contacted patients affiliated with ID services within 72 hours of discharge to identify and intervene on needs such as AM access and management, toxicity monitoring, AM administration teaching, and to assess discharge care progression. The goal of this intervention was to leverage the subject matter expertise of an ID-trained pharmacist to create a protocolized intervention to improve the inpatient-to-outpatient transition for ID patients. METHODS: During a 12 week time period, 173 patients were identified and enrolled in the ID DOOR intervention. Patients who received consultative care by an ID physician were tracked and automatically referred to ID DOOR; those discharged on antimicrobials were included in the intervention group. Phone-based assessment of discharge AM access, education, and administration was initiated by the ID pharmacist within 72 hours of discharge (Table 1). RESULTS: Of the 173 patients, 155 (90%) were successfully contacted post-discharge. The majority of needs identified were AM education, access, and coordination of care (Table 2). In addition, discrepancies between discharge orders, summary content, and patient instructions were prevalent. Based on the medication-related assessment performed by the ID-trained pharmacists, they were able to resolve AM-related issues and identify, triage, and link patients to appropriate multidisciplinary providers to coordinate care plans. CONCLUSION: The data highlight the prevalence of immediate post-discharge needs related to antimicrobial for patients and the critical role of ID-trained pharmacists in addressing these needs. In a large public academic medical center with uninsured and underinsured patients, additional support for AM access, education, and navigation of care plans is needed. For medically and socially complex ID patients, an ID-trained pharmacist plays a critical role in reducing risk inherent in the transition from inpatient to outpatient care. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810949/ http://dx.doi.org/10.1093/ofid/ofz360.815 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Walston, Bobbi Jo
Fletcher, Lisa A
Wilson, William
Boerneke, Renae A
Marx, Ashley H
Vargas, John D
Farel, Claire E
747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program
title 747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program
title_full 747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program
title_fullStr 747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program
title_full_unstemmed 747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program
title_short 747. Implementation of a Pharmacist-led Intervention for Infectious Diseases Patients Discharged on Antimicrobials: the Infectious Diseases Discharge Outreach and Retention (ID DOOR) Program
title_sort 747. implementation of a pharmacist-led intervention for infectious diseases patients discharged on antimicrobials: the infectious diseases discharge outreach and retention (id door) program
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810949/
http://dx.doi.org/10.1093/ofid/ofz360.815
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