Patient-perceived understanding of home-going medication with transitions of care services at a pediatric institution.

BACKGROUND: Transitions of care (TOC) is the coordination and continuity of healthcare as a patient transfers between different settings.1 This can include a wide range of services, such as medication reconciliation, patient counseling, bedside delivery of medications, and others that meet individual patient needs.2 In the pediatric population, patients are at increased risk of potential medication errors and subsequent harm due to reduced patient and/or caregiver health literacy, limited dosage form availability, and errors in medication administration.5 The use of TOC services at the time of hospital discharge in this population has the potential to make a positive impact on patient safety and the treatment of medical conditions.

OBJECTIVES: The primary objective of this study was to determine if patient-perceived understanding of home-going medications was greater in patients and/or caregivers that received medication bedside delivery and education from a pharmacy-led TOC service at a large, pediatric academic medical center. The secondary objective was to determine if the primary practice area of the pharmacist providing medication education led to changes in understanding of home-going medication(s).

METHODS: Using institution-wide, patient satisfaction surveys from January 1, 2021, through December 31, 2021, patient and/or caregiver responses were queried for two questions about home-going medications, relating to the understanding of administration and the potential side effects. Patients were divided into two groups depending on TOC services received, as documented in the electronic medical record (EMR). Survey responses for each of the two questions were categorized as top-box percentage by study group. Hypothesis testing between study groups for the primary and secondary outcomes were conducted using chi-squared tests at an alpha of 0.05. Statistical analyses were conducted using SAS version 9.4.

RESULTS: Of the 1,159 patients included in the study, 441 received TOC services, deemed the intervention group, and 718 did not receive TOC services, deemed the control group. When the intervention and control group were asked about understanding of medication administration, 96.37% versus 93.18% (p=0.007) of patients gave the most favorable response of "yes, definitely," respectively. Further, 78.51% versus 77.44% (p=0.053) of patients gave the most favorable response when asked about understanding potential medication side effects, respectively.

CONCLUSION: Patients receiving TOC services by a member of the pharmacy team had a greater score for understanding of both medication administration and side effects. Furthermore, this greater score was consistent among the education provided by the inpatient and outpatient pharmacist.