Reducing hospital admissions for adverse drug events through coordinated pharmacist care: learning from Hawai’i without a field trip

Steinman, Michael A.

doi:10.1136/bmjqs-2018-008815

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…33 Studies have identified that medication errors are most prevalent at transition from hospital to the home/care facility, and can contribute to medication harm, effect continuity of care and instigate readmission. [34][35][36][37] For example, only 25% of discharge summaries to general practitioners have a complete medication list. 35 Furthermore, in Australia it is estimated that between 15% and 50% of all older adults will experience medication harm within 30 days of returning hospital discharge.…”

Section: At Dischargementioning

confidence: 99%

The right time and place: the need for seven‐day pharmacist service models

Falconer

Snoswell

Morris

et al. 2021

Pharmacy Practice and Res

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Background: Medication safety is a World Health Organization health priority, with recognition that greater focus is needed to address this long-standing healthcare challenge. As medication management experts, hospital pharmacists support the safe and quality use of medications and are ideally positioned to optimise medication safety throughout a patient's hospital journey. However, hospital pharmacist services are commonly limited to business hours. Aim: To synthesise evidence for best practice hospital pharmacist services, with a focus on transitions of care, in support of an extended hours seven-day service model. Method: A literature search was conducted using PubMed, Embase and Google Scholar to identify studies that evaluated the provision of a seven-day hospital pharmacist service. Primary studies containing keywords '7-day service' OR 'after hours service' OR '24-h service' AND 'hospital pharmacist' OR 'clinical pharmacist' AND 'inpatient' OR 'hospital', and related synonyms in the title and/or abstract, published to December 2019, were identified. Additionally, highly cited studies related to hospital pharmacist services were also reviewed to evaluate benefits during hospitalisation. A narrative synthesis was conducted. Results: Only two studies have evaluated the benefits of seven-day services. A large number of studies, reporting hospital pharmacist services during inpatient admission support the need for pharmacist services beyond the 8-5 model. These studies demonstrate the vital role of pharmacists in medication management across the continuum of care. Conclusion: Hospital pharmacists are essential in ensuring optimal patient outcomes; however, few studies have appraised extended pharmacy services. To deliver equitable patient-centred care, a robust evaluation of seven-day services is needed.

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Section: At Dischargementioning

confidence: 99%

The right time and place: the need for seven‐day pharmacist service models

Falconer

Snoswell

Morris

et al. 2021

Pharmacy Practice and Res

View full text Add to dashboard Cite

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“…While the best strategies to combat PIM use in primary care remain unclear [ 17 , 21 , 22 ], effective transitional pharmacist-led strategies have been described [ 23 – 28 ]. They have included medicine reconciliation and review in the context of multidisciplinary care, patient counselling, communication with primary care providers and post-discharge follow-up.…”

Section: Introductionmentioning

confidence: 99%

Uptake of pharmacist recommendations by patients after discharge: Implementation study of a patient-centered medicines review service

2023

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Background Polypharmacy and potentially inappropriate medicine use is common in older people, resulting in harm increased by lack of patient-centred care. Hospital clinical pharmacy services may reduce such harm, particularly prevalent at transitions of care. An implementation program to achieve such services can be a complex long-term process. Objectives To describe an implementation program and discuss its application in the development of a patient-centred discharge medicine review service; to assess service impact on older patients and their caregivers. Method An implementation program was begun in 2006. To assess program effectiveness, 100 patients were recruited for follow-up after discharge from a private hospital between July 2019 and March 2020. There were no exclusion criteria other than age less than 65 years. Medicine review and education were provided for each patient/caregiver by a clinical pharmacist, including recommendations for future management, written in lay language. Patients were asked to consult their general practitioner to discuss those recommendations important to them. Patients were followed-up after discharge. Results Of 368 recommendations made, 351 (95%) were actioned by patients, resulting in 284 (77% of those actioned) being implemented, and 206 regularly taken medicines (19.7 % of all regular medicines) deprescribed. Conclusion Implementation of a patient-centred medicine review discharge service resulted in patient-reported reduction in potentially inappropriate medicine use and hospital funding of this service. This study was registered retrospectively on 12th July 2022 with the ISRCTN registry, ISRCTN21156862, https://www.isrctn.com/ISRCTN21156862.

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“…3 With their expertise in identifying and addressing drug-related problems, pharmacists have played a central role in some of the most promising TOC interventions to reduce MRH. [4][5][6] Systematic reviews of pharmacist-led TOC interventions have documented the heterogeneity of these interventions, [7][8][9] the lack of evidence of the most beneficial TOC model, [7][8][9] and the improved results with multifaceted interventions, 7 or interventions of higher intensity. 10 One promising pharmacist-led TOC model involves having the hospital pharmacist develop a pharmaceutical care plan and then transfer it at hospital discharge to the primary care clinicians, mainly the dispensing community pharmacist and the family physician, who carry out the TOC interventions.…”

Section: Introductionmentioning

confidence: 99%

“…In 2017, the World Health Organization (WHO) launched their Third Global Patient Safety Challenge: Medication Without Harm , which aims to reduce MRH by 50% over 5 years in three key action areas: high‐risk situations, polypharmacy and TOC interventions 3 . With their expertise in identifying and addressing drug‐related problems, pharmacists have played a central role in some of the most promising TOC interventions to reduce MRH 4–6 …”

Section: Introductionmentioning

confidence: 99%

Pharmacist‐led transitions of care between hospitals, primary care clinics, and community pharmacies

Cossette

Ricard

Poirier

et al. 2021

J American Geriatrics Society

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Background: Pharmacist-led transitions of care (TOC) interventions have been described as some of the most promising interventions to reduce medication-related harm (MRH) in older adults. This study analyzed the feasibility of pharmacist-led TOC interventions between hospitals, multidisciplinary primary care clinics (PCC), and community pharmacies.Methods: Adults aged 65 years and older at risk of MRH in three regions of Quebec, Canada, with contrasting contexts of care based on university affiliation were recruited in this multicenter, single arm, and prospective intervention cohort. The hospital pharmacist developed the pharmaceutical care plan in collaboration with the hospital physician and transferred this plan with the hospitalization summary, at hospital discharge, to the PCC family physician and to the community and PCC pharmacists. A consultation with the community pharmacist was scheduled within seven days of hospital discharge and with the PCC pharmacist when appropriate. Feasibility outcomes included the time to complete the interventions and their location. Results:The 123 eligible patients had a mean age of 78.5 years, and 63.4% were females. The most frequent inclusion criterion was 10 medications or more, including one high-risk medication for 90 patients (73%). Recruitment in one region was stopped after three months due to unsuccessful recruitment of key PCC. The hospital pharmacist interventions took a median of 165 min.The first consultations of the PCC and community pharmacists took a median of 15 and 50 min. Among the 96 patients with a post-discharge pharmacist follow-up, 23 (24.0%) had a consultation with a PCC pharmacist, with 65.2% of the consultations conducted at the PCC. The community pharmacists conducted a consultation with 88 patients (93%), with more than 70% of consultations conducted by phone.

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Reducing hospital admissions for adverse drug events through coordinated pharmacist care: learning from Hawai’i without a field trip

Cited by 4 publications

References 17 publications

The right time and place: the need for seven‐day pharmacist service models

The right time and place: the need for seven‐day pharmacist service models

Uptake of pharmacist recommendations by patients after discharge: Implementation study of a patient-centered medicines review service

Pharmacist‐led transitions of care between hospitals, primary care clinics, and community pharmacies

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