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Effectiveness of post-hospital discharge pharmacist care on clinical outcomes.
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  • Jaclyn Costello,
  • Michael Barras,
  • Holly Foot,
  • William Cottrell
Jaclyn Costello
The University of Queensland School of Pharmacy

Corresponding Author:[email protected]

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Michael Barras
University of Queensland School of Pharmacy
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Holly Foot
Univ Queensland
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William Cottrell
The Univeristy of Queensland
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Abstract

BACKGROUND: Clinic pharmacists have been shown to identify and resolve medication related problems post-discharge, however, the impact on patient clinical outcomes is unclear. AIMS: To identify hospital-based post-discharge pharmacist clinics that provide medication review; report the patient clinical outcomes measured; and describe the activities of the clinical pharmacist. METHODS: Published studies evaluating a patient clinical outcome following a post-discharge hospital clinic pharmacy service were included. All studies needed a comparative design (intervention vs usual care). Pubmed, Embase, CINAHL, PsycnINFO, Web of Science, IPA and APAIS-Health databases were searched to identify studies. The type of clinic and the clinical pharmacist activities were linked to patient clinical outcomes. RESULTS: Fifty-seven studies were included in the final analysis, 14 randomised controlled trials and 43 non-randomised studies. Three key clinic types were identified: post-discharge pharmacist review alone, inpatient care plus post-discharge review and post-discharge collaborative clinics. The three main outcome metrics identified were hospital readmission and/or representation, adverse drug events, and improved disease state metrics. There was often a mix of these outcomes reported as primary and secondary outcomes. High heterogeneity of interventions and clinical pharmacist activities reported meant it was difficult to link clinical pharmacist activities with the outcomes reported. CONCLUSIONS: A post-discharge clinic pharmacist may improve patient clinical outcomes such as hospital readmission and representation rates. Future research needs to provide a clearer description of the clinical pharmacist activities provided in both arms of comparative studies.