We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Evaluation of a care transition program with pharmacist-provided home-based medication review for elderly Singaporeans at high risk of readmissions.
- Authors
MCVIN HUA HENG CHEEN; CHONG PING GOON; WAN CHEE ONG; PAIK SHIA LIM; CHOON NAM WAN; MEI YAN LEONG; GIAT YENG KHEE; Cheen, McVin Hua Heng; Goon, Chong Ping; Ong, Wan Chee; Lim, Paik Shia; Wan, Choon Nam; Leong, Mei Yan; Khee, Giat Yeng
- Abstract
<bold>Objective: </bold>This study aimed to determine whether pharmacist-provided home-based medication review (HBMR) can reduce readmissions in the elderly.<bold>Design: </bold>Retrospective cohort study.<bold>Setting: </bold>Patient's home.<bold>Participants: </bold>Records of patients referred to a care transition program from March 2011 through March 2015 were reviewed. Patients aged 60 years and older taking more than 5 medications and had at least 2 unplanned admissions within 3 months preceding the first home visit were included.<bold>Intervention: </bold>Pharmacist-provided HBMR.<bold>Main Outcome Measures: </bold>Primary outcome was readmission rate over 6 months after the first home visit. Secondary outcomes included emergency department (ED) visits, outpatient visits and mortality. Drug-related problems (DRPs) were reported for the HBMR group. Multivariate incidence rate ratios (IRR) and hazard ratio (HR) were calculated with adjustments for covariates.<bold>Results: </bold>The study included 499 patients (97 HBMR, 402 no HBMR). Pharmacist-provided HBMR reduced readmissions by 26% (IRR = 0.74, 95% CI: 0.59-0.92, P = 0.007), reduced ED visits by 20% (IRR = 0.80, 95% CI: 0.66-0.98, P = 0.030) and increased outpatient visits by 16% (IRR = 1.16, 95% CI: 0.95-1.41, P = 0.150). There were 8 and 44 deaths in the HBMR and no HBMR groups respectively (HR = 0.73, 95% CI: 0.29-1.81, P = 0.492). Pharmacists identified 464 DRPs, with 169 (36.4%) resolved within 1 month after the home visit.<bold>Conclusions: </bold>The study suggests that pharmacist-provided HBMR is effective in reducing readmissions and ED visits in the elderly. More studies in the Asian population are needed to determine its long term benefits and patient's acceptability.
- Subjects
SINGAPORE; OLDER people; PHARMACISTS; DRUGS; PATIENT readmissions; MEDICAL care; PREVENTION of drug side effects; COMPARATIVE studies; HOSPITAL pharmacies; HOSPITAL emergency services; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MORTALITY; RESEARCH; EVALUATION research; DISCHARGE planning; RETROSPECTIVE studies; MEDICATION reconciliation
- Publication
International Journal for Quality in Health Care, 2017, Vol 29, Issue 2, p200
- ISSN
1353-4505
- Publication type
journal article
- DOI
10.1093/intqhc/mzw150