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PEDIATRICS

Impact of Pharmacists' Interventions on the Pediatric Discharge Medication Process

Clinical Pharmacist, Service de Pharmacie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

Steven R Kayser, PharmD

Professor of Clinical Pharmacy, Department of Clinical Pharmacy, School of Pharmacy, University of California at San Francisco, San Francisco, CA

Chi Y Chang, PharmD

Senior Medical Information Associate, Department of Medical Communications, Gilead, Foster City, CA

Q Laura Chang, PharmD

Assistant Clinical Professor, Department of Clinical Pharmacy, School of Pharmacy, University of California at San Francisco

Sharon L Youmans, PharmD

Assistant Professor of Clinical Pharmacy, Department of Clinical Pharmacy, School of Pharmacy, University of California at San Francisco

Reprints: Sharon L Youmans PharmD, UCSF School of Pharmacy, Department of Clinical Pharmacy, 521 Parnassus St., San Francisco, CA 94143-0622, fax 415/476-6632, sly{at}itsa.ucsf.edu

BACKGROUND: To our knowledge, as of August 19, 2004, the impact of pharmacists' interventions on pediatric patients and their caregivers' ability to obtain discharge medications from community pharmacies in a timely fashion has not been described.

OBJECTIVE: To evaluate the impact of pharmacists' interventions on patients' likelihood of obtaining medications within 24 hours of hospital discharge.

METHODS: Patients meeting study criteria were randomized to an intervention or control group. The intervention was a proactive program of discharge planning by the pharmacy team. All study patients received a follow-up telephone interview to assess the amount of time needed to obtain medications and caregivers' knowledge of how to administer medications. A multivariate linear regression was conducted to assess the association between variables such as insurance, place of residence, number of prescribed medications, and the probability to obtain medications within 24 hours of hospital discharge.

RESULTS: The final analysis included 81 control patients and 91 intervention patients. After controlling for a number of factors, the intervention group was able to have obtained medications within 24 hours more often than the control group (84% vs 69%; p = 0.027). Caregivers' knowledge of how to correctly administer medications did not differ between the 2 groups.

CONCLUSIONS: Our results suggest that the coordinated efforts of pharmacists' interventions during the discharge process may have a positive impact. Our observations may be used to establish criteria for identifying patients at risk for problems with obtaining medications at discharge.

Key Words: discharge medications, pediatrics, pharmacist intervention

Published Online, August 24, 2004. www.theannals.com, DOI 10.1345/aph.1E087

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