Discharge Patient Education
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Discharge Patient Education Resources

Corresponding PPMI Recommendations

B23m: Discharge education is considered an essential pharmacist provided drug therapy management activity.

Wisconsin Transitions of Care Survey Results

  • 66% of sites have an interest in implementing discharge education
  • 54% of sites state that pharmacy has a role in discharge education
  • 33% of sites state the education occurs during their patient stay
  • 67% of sites state the education occurs immediately prior to discharge
  • 83% of sites state the education or medication reconciliation is documented in the EMR

Guideline Statements

ASHP Policy 1222: Medication Adherence
To recognize that improving medication adherence should be a key component of strategies to improve the quality and safety of patient care only when adherence improvement efforts include the following as required elements

  1. Assessing the appropriateness of therapy
  2. Providing patient education
  3. Ensuring patient comprehension of information necessary to support safe and appropriate use of prescribed therapies

ASHP–SHM Joint Statement on Hospitalist–Pharmacist Collaboration
Pharmacists should be involved in the care of hospitalized patients and can collaborate with hospitalists in numerous ways, including providing patient and caretaker education, including discharge counseling and follow-up.

ASHP Guidelines on Pharmacist-Conducted Patient Education and Counseling
Providing pharmaceutical care entails accepting responsibility for patients’ pharmacotherapeutic outcomes. Pharmacists can contribute to positive outcomes by educating and counseling patients to prepare and motivate them to follow their therapeutic regimens and monitoring plans.

ACCP Practice Guidelines for Pharmacotherapy Specialists
Guideline IV: The pharmacotherapy specialist educates health care professionals and students, patients, and the public regarding rational drug therapy. Assessment Factors:

  1. Assumes responsibility for the education of all members of the health care team involved in patient pharmacotherapy
  2. Participates in continuing education programs concerning pharmacotherapeutics
  3. Develops patient education materials and participates in patient instruction programs to facilitate appropriate medication therapy and compliance

Staff Development Resource

Lee AJ, Borham A, Korman NE, Keeney BE, Mock ED. Staff development in pharmacist-conducted patient education and counseling. Am J Health Syst Pharm. 1998 Sep 1;55(17):1792-8.

References can be viewed here.

High Impact Focus Areas

Drug Classes  Disease States 
Antiarrhythmics 2 Asthma 15,16 
Antibiotics 3 Cancer 13 
Anticoagulants 4,5 Chronic Kidney Disease
Antidiabetic agents 6 COPD* 14 
Antiplatelets 7  Diabetes 6
Antipsychotics 8 Heart Failure* 17 
Antivirals 9 Myocardial Infarction* 18 
Immunosuppressants 10-12  Pneumonia* 
Oral chemotherapy 13 Psychotic Disorders 8 
Respiratory agents 14,15 Transplant 10-12