Lessons Learned in the Evaluation of Hospital Admissions for Patients with Heart Failure Seen by a Pharmacist in Addition to a Nurse Practitioner, Compared to a Nurse Practitioner Alone
by Alexis T. Mowry, PharmD, Karrie A. Stanke, PharmD, BCPS
"Objective: Compare hospital admission rates for patients seen by a pharmacist in collaboration with a nurse practitioner, versus a nurse practitioner alone.
Methods: Two evaluators collaborated in a retrospective chart review of patients with congestive heart failure (CHF) who were seen in an outpatient cardiology clinic. The first evaluator selected 40 patients: 20 who saw a nurse practitioner (NP) and a pharmacist (RPh), and 20 who saw an NP alone. The evaluator matched the groups according to a heart failure admission risk score. A second evaluator, who was blinded to the groups, performed the data collection and analysis. The primary outcome was the number of hospital admissions at 30, 60, and 90 days post-cardiology clinic visit. A two-tailed student’s t-test was used to detect statistically significant differences in the number of all-cause admissions between the two groups, with a p-value of less than 0.05 considered significant. Results: The number of hospital admissions was lower in the RPh+NP group compared to the NP-only group at 30 (2 admissions RPh+NP vs. 4 admissions NP; p=0.389), 60 (4 admissions RPh+NP group vs. 5 admissions NP; p=0.714), and 90 days (4 admissions RPh+NP vs. 7 admissions NP; p=0.300) post-cardiology clinic visit, but not statistically significantly different for any of the time points evaluated.
Conclusions: Although not statistically significant, there were fewer hospital admissions in the interdisciplinary group compared to the NP-only group, which could support an expansion of pharmacist services in the outpatient cardiology clinic."
Keywords: United States, Pharmacists, Patient Discharge, Patient Readmission, Control Groups, Hospitalization, Heart Failure, Medication Adherence, Hospitals, Emergency Service, Hospital
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2021 November/December Table of Contents
"Objective: Compare hospital admission rates for patients seen by a pharmacist in collaboration with a nurse practitioner, versus a nurse practitioner alone.
Methods: Two evaluators collaborated in a retrospective chart review of patients with congestive heart failure (CHF) who were seen in an outpatient cardiology clinic. The first evaluator selected 40 patients: 20 who saw a nurse practitioner (NP) and a pharmacist (RPh), and 20 who saw an NP alone. The evaluator matched the groups according to a heart failure admission risk score. A second evaluator, who was blinded to the groups, performed the data collection and analysis. The primary outcome was the number of hospital admissions at 30, 60, and 90 days post-cardiology clinic visit. A two-tailed student’s t-test was used to detect statistically significant differences in the number of all-cause admissions between the two groups, with a p-value of less than 0.05 considered significant. Results: The number of hospital admissions was lower in the RPh+NP group compared to the NP-only group at 30 (2 admissions RPh+NP vs. 4 admissions NP; p=0.389), 60 (4 admissions RPh+NP group vs. 5 admissions NP; p=0.714), and 90 days (4 admissions RPh+NP vs. 7 admissions NP; p=0.300) post-cardiology clinic visit, but not statistically significantly different for any of the time points evaluated.
Conclusions: Although not statistically significant, there were fewer hospital admissions in the interdisciplinary group compared to the NP-only group, which could support an expansion of pharmacist services in the outpatient cardiology clinic."
Keywords: United States, Pharmacists, Patient Discharge, Patient Readmission, Control Groups, Hospitalization, Heart Failure, Medication Adherence, Hospitals, Emergency Service, Hospital
Download PDF
2021 November/December Table of Contents