Pharmacist-Led Care Transitions: Best Practices

Opinion
Video

Kristen Peterson, PharmD, BCOP, reviews pharmacists’ pivotal role in optimizing patient transitions between inpatient and outpatient care settings to ensure treatment continuity and medication management in multiple myeloma care.

This is a video synopsis/summary of an Insights episode involving Kristen Peterson, PharmD, BCOP.

As more patients with myeloma receive infusional or cellular therapies requiring inpatient admissions, pharmacists can enable smooth care transitions. When clinical patients are hospitalized, pharmacists thoroughly review medications, noting new/discontinued drugs, formulary differences necessitating patient provision of home medications, and holding/adjusting other treatments such as outpatient diabetes regimens with inpatient insulin protocols. For planned chemotherapy admissions, they confirm all documentation is complete (orders signed, consent obtained) and necessary procedures conducted beforehand (COVID-19 testing, imaging, line placement). When a patient is discharged from the hospital, inpatient pharmacists ensure clinic treatment plans are updated, financial authorizations secured for future infused/oral chemotherapy, costly supportive prescriptions accessible, and any mandated pharmacy education/risk evaluation and mitigation strategy enrollment completed so treatment can start seamlessly.

Pharmacists’ attentiveness to detail and their comprehensive treatment plan knowledge make them ideal candidates to construct electronic medical record order sets for myeloma regimens, subsequently refined with multidisciplinary input. As each team member reviews drafts, they consider unique perspectives to optimize plans. Components that pharmacists incorporate include supportive care/oral chemotherapy prescriptions, nursing communications to flag additional patient needs, hydration/injections and precise timing, prophylactic as-needed medications for predictable adverse events, and infusion reaction treatments.

Video synopsis is AI-generated and reviewed by Pharmacy Times® editorial staff.

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