Pharmacist-led telemental health transitions of care clinic improves antidepressant medication continuity posthospitalization

Abstract

A pharmacist-led telemental health transitions of care clinic was created at a Veterans Affairs Medical Center to improve continuity of psychiatric medication therapy following discharge from an acute psychiatric hospitalization. This was a single-center, multi-site, retrospective cohort study (historical cohort). The primary study objective was to determine the impact of a post-discharge pharmacist-led telemental health transitions of care clinic on improving antidepressant adherence rates after an acute psychiatric hospitalization. Secondary objectives included evaluation of rates of readmission to psychiatric hospitals, time to first mental health provider follow-up, and characterization of various pharmacist interventions made during the clinic visit. Pilot study results support that a pharmacist-led telemental health transitions of care clinic can improve antidepressant adherence after psychiatric hospital discharge and reduce time to postdischarge follow-up with a mental health provider. Patients enrolled in the clinic were more likely to maintain a medication possession ratio .0.8 within 90 days of discharge when compared to a historical control (100% vs 43%, P =.035). The clinic also improved time to first mental health provider follow-up as seen by a statistically significant improvement in the number of patients seen within 14 days of discharge by a mental health provider (100% vs 43%, P=.035). Results highlight the valuable role of psychiatric pharmacists in delivery of transitions of care services and support the expansion of current roles to improve outcomes after psychiatric hospitalizations.