Student-Led discharge counseling program for High-Risk medications in a teaching hospital in Saudi Arabia: A pilot study |
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Authors: | Ghada Bawazeer Ibrahim Sales Afnan Alsunaidi Sarah Aljahili Mohammad H. Aljawadi Haya M. Almalag Hadeel Alkofide Mansour Adam Mahmoud Fakhr Alayoubi Majda Aljohani |
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Affiliation: | 1. Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia;2. Dr. Sulaiman Alhabib Medical Group, P.O. Box 91877, Riyadh 11643, Saudi Arabia;3. Saudi Food and Drug Authority, 4904 Northern Ring Branch Rd., Hittin District, Unit number: 1, Riyadh 13513 – 7148, Saudi Arabia;4. Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Mohamed bin Naif Road, Al-Madinah Al-Munawarah 42353, Saudi Arabia;5. Corporate of Pharmacy Services, King Saud University Medical City, Riyadh 12746, Saudi Arabia;6. King Saud Medical City, Al Imam Abdulaziz Bin Mohammad Bin Saud Street 7610, Riyadh 12746, Saudi Arabia |
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Abstract: | Discharge counseling by pharmacists reduces adverse medication events, emergency department visits, and readmissions. Studies indicate that pharmacy students in advanced pharmacy practice experiences (APPE) can deliver effective medication-related activities. An open label randomized controlled trial was conducted in adults discharged on warfarin, insulin, or both. Pharmacy students performed medication reconciliation, structured medication counseling, and follow-up calls 72-hours post-discharge. The usual care arm received traditional education. The primary outcome was the 30-day readmission rate post-discharge. Ninety-eight patients on high-risk medications were randomized to intervention (n = 51) or usual care (n = 47). The 30-day hospital readmission rate was lower in the intervention group (8/51, 15% vs. 11/47, 23%); (p = 0.48). There was no statistical difference in the time to first unplanned health care use (hazard ratio = 0.49 (95 %CI, 0.19–1.24), or the time-to-first clinic visit post-discharge (p = 0.94) between the two arms. Students identified 26 drug-related problems during reconciliation. Patients in the intervention arm reported high satisfaction with the service (mean 3.94; SD 0.11). Involving APPE students in the transition of care activities presents an excellent opportunity to minimize pharmacists' workload while maintaining patient care services. |
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Keywords: | Transitions of care Discharge counseling Pharmacy Students Medication Reconciliation Medication counseling Post-discharge follow up Drug-related problems |
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