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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Impact of a Pharmacist-Driven Poststroke Transitions of Care Clinic on 30 and 90-Day Hospital Readmission Rates
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Impact of a Pharmacist-Driven Poststroke Transitions of Care Clinic on 30 and 90-Day Hospital Readmission Rates

机译：药剂师驱动的监护诊所的影响转型30和90天医院入院率

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Background: Stroke impacts nearly 800,000 people annually and the risk of recurrent stroke and hospital readmission is increased early following the initial event. Due to the increase in morbidity and mortality associated with secondary events, a pharmacist-driven poststroke transitions of care clinic was created at Methodist University Hospital to provide risk factor modification in an effort to decrease risk of recurrence and hospital readmissions. Methods: A retrospective matched-cohort study was conducted between 9/1/2017 and 2/28/2019. Adult patients with a primary diagnosis of stroke, discharged to home, and attended a poststroke transitions of care clinic visit were included. Patients were matched on the basis of age +/- 3 years, race, gender, and type of stroke to those who did not receive pharmacist intervention during the same time period. The primary endpoint was 30-day hospital readmissions. Secondary endpoints included 90-day readmissions, 30 and 90-day emergency department visits, and recurrent stroke rates. Type and quantity of pharmacist interventions was also assessed. Results: One hundred and eightyeight patients were included in the analysis. Baseline differences existed between the groups in the following: history of transient ischemic attack, stroke severity score, and insurance status. No significant difference was found in 30-day readmissions. There was a significant difference found in 90-day readmissions (5.3% versus 21.3%, P = .001). There were no significant differences in emergency department utilization at 30 or 90 days or stroke recurrence rates. Pharmacists made a mean of 3.5 interventions made during each visit. Conclusions: Although the primary goal to reduce 30-day readmission was not met, a pharmacist-driven poststroke transitions of care clinic significantly decreased 90-day hospital readmission rates.
机译：背景：中风每年影响近80万人，首次事件发生后，复发性中风和再入院的风险增加。由于与继发事件相关的发病率和死亡率增加，卫理公会大学医院创建了一个由药剂师驱动的中风后护理过渡诊所，以提供风险因素修改，以降低复发风险和再住院风险。方法：于2017年9月1日至2019年2月28日进行回顾性配对队列研究。包括初步诊断为中风、出院回家并参加中风后过渡期护理门诊的成年患者。患者根据年龄+/-3岁、种族、性别和中风类型与同期未接受药剂师干预的患者进行匹配。主要终点是30天的医院再入院。次要终点包括90天的再入院、30天和90天的急诊就诊以及复发性卒中率。还评估了药剂师干预的类型和数量。结果：180名患者被纳入分析。两组之间在以下方面存在基线差异：短暂性脑缺血发作史、中风严重程度评分和保险状况。在30天的再入院中没有发现显著差异。90天再入院率有显著差异（5.3%对21.3%，P=0.001）。在30天或90天的急诊室使用率或中风复发率方面没有显著差异。药剂师在每次就诊期间平均进行3.5次干预。结论：虽然降低30天再入院率的主要目标没有实现，但由药剂师驱动的卒中后转诊诊所显著降低了90天再入院率。

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