Diabetes transitional care from inpatient to outpatient setting: pharmacist discharge counseling.
OBJECTIVE
Diabetes transitional care from the inpatient to outpatient setting is understudied. This study evaluated the effect of inpatient pharmacist discharge counseling on outpatient diabetes medication adherence.


METHODS
Prospective, randomized, controlled study compared pharmacist discharge counseling (intervention) with usual patient care (control) in 127 patients with established diabetes and an A1C ≥8% who had a provider and medications filled within the county health system. The primary outcome was diabetes medication adherence rate measured using the prescription of days covered (PDC) method.


RESULTS
Patients in the intervention, compared with control group, had greater diabetes medication adherence rate 150 days after discharge (55.2% vs 34.8%; P = .002), rate of follow-up visits (60.5% vs 43.9%; P = .01) and reduction in A1C (-1.97% vs +0.114%; P = .003). Being in the intervention group and having greater adherence with follow-up visits correlated independently with lower follow-up A1C.


CONCLUSIONS
Transitional care in the form of inpatient education geared to improve self-management after hospital discharge. This may serve as a paradigm to improve outpatient adherence rate with medications, follow-up visits, and A1C reduction.
Department of Pharmacy Practice, University of Illinois, Chicago, IL 60626, USA. mansirx@gmail.com
Mansi
M
Shah
CaTanya A
CA
Norwood
Sol
S
Farias
Sonia
S
Ibrahim
Pang H
PH
Chong
Leon
L
Fogelfeld
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000379:methods / Q000592:standards* / Q000639:trends; D003266:Continuity of Patient Care / Q000592:standards* / Q000639:trends; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients / Q000193:education; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010045:Outpatients / Q000193:education; D010351:Patient Discharge / Q000592:standards* / Q000639:trends; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards* / Q000639:trends; D010595:Pharmacists / Q000592:standards* / Q000639:trends; D011446:Prospective Studies