An investigation of hospital generated pharmaceutical care when patients are discharged home from hospital

Abstract

Aims To investigate how seamless pharmaceutical care could be delivered. Methods Elderly patients discharged from hospital, to their own home, were randomized into control and study groups. Control and study group patients received the normal discharge information. The study group were also counselled about their medicines and informed about their pharmaceutical care plan. Copies of the plan were given to the study patients. All patients received a domiciliary visit between 7 and 10 days after discharge. Their current medication was compared with that on discharge and contact was made with the General Practitioner as appropriate. Results Twenty‐eight study and 25 control patients with a mean (s.d.) age of 77.5 (7.3) and 77.6 (6.1) years completed the study. A pharmaceutical domiciliary visit was necessary for 21 (75%) and 24 (96%) of the study and control patients respectively. Compliance was better (P<0.01) in the study group. Unintentional changes to the medication of 31 (14 study and 17 control) patients were found during the visit and after contact with the prescriber all but one prescription was restored to that on discharge. Conclusions At present it is difficult to ensure seamless pharmaceutical care. A pharmaceutical domiciliary visit may be useful to ensure seamless therapeutic care and thus avoid unnecessary healthcare events and costs after a patient is discharged home.

Recognition and management of potential drug–drug interactions in patients on internal medicine wards

“…Changes in medication at the transition point from outpatient to inpatient care and vice versa may increase the frequency of drug-related problems such as pDDIs [10,[15][16][17]. In our own study of the prevalence of pDDIs during hospital stay (Vonbach B, unpublished observation), 47% of all pDDIs at discharge were created by medication changes during hospitalization.…”

A Pharmacoepidemiologic Study of Drug Interactions in a Brazilian Teaching Hospital

“…Patients without therapeutic care are more exposed to drug-related problems that may include potential DDI. 5,6 At least 15% of the patients admitted to hospitals have 1 DDI at admission. 1,[7][8][9] The risk of DDI can increase in the hospital because new drugs are often added to an existing drug therapy.…”

Patient Medication Counseling – Patientenberatung zur Entlassungsmedikation

“…Dieses Resultat korreliert mit Aussagen amerikanischer und britischer Studien [1,6,12]. So konnten in der Untersuchung von Cannon et al [1] an 40 älteren Patienten 90% der Beratungsgruppe gegenüber 72,3% der Kontrollgruppe vier Wochen nach Klinikentlassung die richtige Indikation benennen.…”