Research Article Open Access

Student-Led Discharge Counseling Program of High-Risk Medications in a Teaching Hospital in Saudi Arabia: A Pilot Study

Abstract

Background

Discharge counseling by pharmacists can reduce adverse medication events during the transition of care as well as reduce emergency department visits and readmission. The literature showed that pharmacy students in advanced pharmacy practice experience (APPE) can deliver effective medication-related activities.

Method

An open-label, randomized control trial on patients (>18 years) discharged on a high-risk medication (warfarin and/or insulin). Patients were allocated to study arms using simple computer-generated scheme and sequentially numbered, opaque, sealed envelopes. The usual care arm received education from a diabetic or health educator or nothing. The intervention arm received: student-delivered structured counseling, medication reconciliation and a follow-up call at 72-hr post-discharge. The primary outcome was the rate of unplanned health-care utilization at 30-day. Also, feasibility of integrating APPE students in the transition of care activities was explored. Result At the time of this preliminary analysis, 75 patients were randomized; 42 in the intervention arm and 33 in the usual care arm.

Results

showed no difference in the primary outcome at 30-day between intervention (19.05%) and usual care (18.18%), p=0.924. There was no difference in mean time (in days) to first unplanned healthcare utilization (intervention 19.88[9.19]); (usual care 13.5[8.73]), p=0.214. Moreover, there was no difference in time-to-first clinic visit post-discharge (p=0.651) between the two arms. Students identified 19 additional drug-related problems during reconciliation. Only 16% and 53% of patients in usual care received any kind of education upon discharge on warfarin and/or insulin, respectively. Patients in the intervention arm reported high satisfaction with the service provided (mean 3.94[0.11]).

Conclusion

Integrating APPE students in the transition of care activities provided an excellent opportunity to lessen pharmacist’s workload while maintaining patient care services, providing learning opportunities for students and improving patient satisfaction.

AlSunaidi A, AlJahly S, Sales I, AlJawady M, AlMalaq H, AlKofaidi H, AlAyoubi F, and Bawazeer G

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