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Shah et al
patients receiving ATS protocol medications during inpatient
admission were returned to original outpatient therapy. Over
a 6-month period, approximately 15% of patients receiving
ATS protocol medications during inpatient admission were
not returned to original outpatient therapy. Of note, 6% of
these patients were discharged on a different dose or on an
alternative medication.7
In addition, approximately 10% of identified encounters
in this study did not utilize ATS protocols; therefore, targeted
education efforts within our institution will help to increase
utilization of protocols and to ensure safe and appropriate
use of medications.
There are notable limitations to this study. A small number of P&T Committee-approved ATS protocols were
evaluated in comparison to the greater than 100 P&T
Committee-approved ATS protocols actively utilized at
UNC Medical Center. However, we aimed to purposefully
select ATS protocols which represented a broader range of
therapeutic classes and represented medications commonly
used to manage chronic conditions such as diabetes and
chronic obstructive pulmonary disease. We were also
unable to assess clinical impact (eg, adherence, adverse
drug events) of ATS-related discharge discrepancies due to
the complexity of outpatient follow-up. Also, due to variability of documentation in our electronic health record
and the retrospective design, it was challenging to discern
if each omission was based on clinical reason or error during the reconciliation process unless it was specifically
documented.

Conclusion
Overall, this study identified a 91% rate of appropriate reconciliation of ATS protocols at the time of discharge, which
illustrates ATS protocols can be a safe medication management strategy if implemented and utilized appropriately in
the inpatient setting. There are opportunities to ensure ATS
protocols continue to be an effective strategy, specifically
through pharmacist-led efforts to improve discharge medication reconciliation, as 9% of ATS protocol encounters were
incorrectly reconciled at the time of discharge.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

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