A novel approach to medicines optimisation post-discharge from hospital: pharmacist-led medicines optimisation clinic.

ABSTRACT: Background There is a major drive within healthcare to reduce patient readmissions, from patient care and cost perspectives. Pharmacist-led innovations have been demonstrated to enhance patient outcomes. Objective To assess the impact of a post-discharge, pharmacist-led medicines optimisation clinic on readmission parameters. Assessment of the economic, clinical and humanistic outcomes were considered. Setting Respiratory and cardiology wards in a district general hospital in Northern Ireland. Method Randomised, controlled trial. Blinded random sequence generation; a closed envelope-based system, with block randomisation. Adult patients with acute unplanned admission to medical wards subject to inclusion criteria were invited to attend clinic. Analysis was carried out for intention-to-treat and per-protocol perspectives. Main Outcome Measure 30-day readmission rate. Results Readmission rate reduction at 30 days was 9.6% (P?=?0.42) and the reduction in multiple readmissions over 180-days was 29.1% (P?=?0.003) for the intention-to-treat group (n?=?31) compared to the control group (n?=?31). Incidence rate ratio for control patients for emergency department visits was 1.65 (95% CI 1.05-2.57, P?=?0.029) compared with the intention-to-treat group. For unplanned GP consultations the equivalent incident rate ratio was 2.00 (95% CI 1.18-3.58, P?=?0.02). Benefit to cost ratio in the intention-to-treat and per-protocol groups was 20.72 and 21.85 respectively. Patient Health Related Quality of Life was significantly higher at 30-day (P?

SUBMITTER: Odeh M 

PROVIDER: S-EPMC7476989 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature