Affiliations: [a] Department of Pharmacy Practice, Wilkes University, Wilkes-Barre, PA, USA
| [b] Department of Population Health Sciences Geisinger, Geisinger Health System, Danville, PA, USA
| [c] Vanderbilt Discharge and Transitions, Vanderbilt University Medical Center, Nashville, TN, USA
| [d] Enterprise Pharmacy, Geisinger Health System, Danville, PA, USA
| [e] Medicine Institute, Geisinger Health System, Danville, PA, USA
Corresponding author: Thomas W. Davis, MD, Director, Comprehensive Care Clinic, Medicine Institute, Geisinger Health System, 100 N Academy Ave, Danville, PA 17821, USA. Tel.: +1 5702716520; Fax: +1 2153009099; E-mail: [email protected].
Abstract: PURPOSE:Transitional care for adolescents with complex diseases, who are entering adulthood, is challenging. The purpose of this study is to quantify the disease and medication burden of this population, who are transitioning though an interdisciplinary specialty clinic. METHODS:This study is a retrospective observational study of all patients seen in a transitional care clinic between July 2012 and March 2015. The main outcomes assessed included disease state and medication burden. Descriptive statistics, along with the paired t-test and McNemar’s test, were used. RESULTS:The study cohort included 216 patients. The median patient age was 20.7 years, and the median number of clinic encounters was 6. Patients had at least 1 of 8 primary diagnoses. On average, patients took medications from 5 classes and used 3 dose forms. Among 163 patients who had medication reconciliation performed, the average number of medication classes increased by 0.44±1.53 (p = 0.0003). There was an average increase of 3.70%(SD±36.31%; p = 0.27) in the number of required medication lab assessments ordered for patients who had medication reconciliation performed. CONCLUSION:There is a high disease and medication burden among adolescent patients with complex disease states who are to transition to adult care.
Keywords: Complex care, pharmacist, polypharmacy, transitions