Evidence map›Paper›PMID 37611896›Full record

Trial reportJournal of the American Pharmacists Association : JAPhA

Clinical and economic effectiveness of a pharmacy and primary care collaborative transition of care program.

David M Jacobs, Erin Slazak, Christopher J Daly, Collin Clark, Samantha Will, Drake Meaney, Victoria Iervasi, Caroline Irwin, Jingtao Zhu, William Prescott and 2 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Pharmacists Association : JAPhA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

David M Jacobs
Erin Slazak
Christopher J Daly
Collin Clark
Samantha Will
Drake Meaney
Victoria Iervasi
Caroline Irwin
Jingtao Zhu
William Prescott
Gregory E Wilding
Ranjit Singh

Funding

University of Buffalo Clinical and Translational Science Institute - Supplement SchulyerUL1TR001412 · NCATS · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI MURPHY, TIMOTHY F · 2015 to 2024
$33.8M
UB Clinical Scholar Program in Implementation Science to Achieve Triple AimsK12HL138052 · NHLBI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI CANTY, JOHN M, SINGH, RANJIT · 2017 to 2021
$3.1M
Integrative Informatics Approach to Predict Readmissions and Improve Outcomes in COPDK23HL153582 · NHLBI · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI JACOBS, DAVID · 2021 to 2025
$962k
NCATS NIH HHS UL1 TR001412NHLBI NIH HHS K12 HL138052NHLBI NIH HHS K23 HL153582
6 · The paper itself

Abstract

backgroundPrimary care pharmacists are uniquely positioned to improve care quality by intervening within care transitions in the postdischarge period. However, additional evidence is required to demonstrate that pharmacist-led interventions can reduce health care utilization in a cost-effective manner. The study's objective was to evaluate the clinical and economic effectiveness of a pharmacy-led transition of care (TOC) program within a primary care setting.

methodsThis cluster randomized trial was conducted between 2019 and 2021 and included three primary care practices. Eligible patients were ≥18 years of age and at high risk of readmission. The multifaceted pharmacy intervention included medication reconciliation, comprehensive medication review, and patient and provider follow-up. The primary composite endpoint included hospital readmissions and emergency department (ED) visits within 30 days of discharge. Differences in outcomes were modeled using a generalized estimated equations approach and outcomes were assumed to be distributed as a Poisson random variable. A cost-benefit analysis was embedded within the study and estimated economic outcomes from a provider group/health system perspective. Cost measures included: net benefit, benefit to cost ratio (BCR), and return on investment (ROI).

resultsOf 300 eligible patients, 36 were in the intervention group and 264 in the control group. The intervention significantly reduced the primary composite outcome of all-cause readmissions and ED visits within 30 days (adjusted incidence rate ratio [aIRR], 0.54; 95% CI, 0.44-0.66; P < 0.001). There were significant reductions in both 30-day all-cause readmissions (aIRR, 0.64; 95% CI, 0.60-0.67; P < 0.001) and ED visits (aIRR, 0.25; 95% CI, 0.20, 0.31; P < 0.001) between groups. The net benefit of the intervention was $9,078, with a BCR of 2.11 and a ROI of 111%. Sensitivity analyses were robust to changes in economic inputs.

conclusionThis care transition program had positive clinical and economic benefits, providing further support for the essential role pharmacists demonstrate in providing TOC services.

Indexed as

PharmacyPharmacy Service, HospitalAftercareHumansMedication ReconciliationPatient DischargePatient ReadmissionPatient TransferPharmacists

Identifiers

PMID37611896
PMCPMC10900124

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.