From: Effect of a care transition intervention by pharmacists: an RCT
 | Enhanced | Minimal | P-values |
---|---|---|---|
 | n = 311 | n = 312 |  |
Admission medication reconciliation | 311 (100%) | 312 (100%) | Â |
Community pharmacy contacted | 300 (96.5%) | 305(97.8%) | 0.34 |
Discharge counseling completed | 235 (75.6%) | 235 (75.3%) | 0.94 |
Wallet card completed | 309 (99.4%) | 308 (98.7%) | 0.41 |
Medication issues identified in hospital | 275 (88.4%) | 249 (79.8%) | 0.003 |
Post-discharge phone call completed | 301 (96.8%) | 4 (1.3%)* | Â |
Discharge care plan faxed to community physician | 267 (85.9%) | 1 (0.3%)* | Â |
Discharge care plan faxed to community pharmacist | 246 (79.1%) | 1 (0.3%)* | Â |
Discharge care plan included medication recommendations to community physician | 207 (66.6%) | NA | Â |
Discharge care plan medication issues identified by pharmacists†| To Hospital & Community Physicians | To Hospital Physicians |  |
  Mean (±SD) | 6.6 (±6.8) | 3.2 (±4.0) |  |
  Total number of issues identified | 2063 | 1012 |  |
  Dosing or administration | 260 | 131 |  |
  Indication | 754 | 363 |  |
  Efficacy | 319 | 101 |  |
  Cost | 103 | 38 |  |
  Risk to patient | 627 | 379 |  |
Discharge care plan recommendations made to physicians†| To Hospital & Community Physicians | To Hospital Physicians |  |
  Mean (±SD) | 7.1 (±6.6) | 3.5 (±3.8) |  |
  Total number of recommendations | 2220 | 1077 |  |
  Discontinue medications | 377 | 195 |  |
  Add medications | 566 | 256 |  |
  Change medications | 361 | 151 |  |
  Disease monitoring | 280 | 56 |  |
  Follow-up patient | 262 | 134 |  |
  Patient education | 283 | 239 |  |
  Adherence education | 91 | 46 |  |
Time pharmacist spent on each patient (minutes) | 210.0 (±93.0) | 118.5 (±58.6) | <.0001 |