Article Text

Person-centred pharmaceutical care reduces emergency readmissions
  1. Julia Blagburn1,
  2. Ben Kelly-Fatemi1,
  3. Nasima Akhter2,
  4. Andy Husband3
  1. 1Pharmacy Department, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle-upon-Tyne, UK
  2. 2Wolfson Research Institute for Health and Wellbeing, Durham University, Queen's Campus, University Boulevard, Thornaby-On-Tees, UK
  3. 3Division of Pharmacy, School of Medicine, Pharmacy and Health, Durham University, Queen's Campus, University Boulevard, Thornaby-On-Tees, UK
  1. Correspondence to Dr Julia Blagburn, Pharmacy Department, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Freeman Hospital, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK; julia.blagburn{at}nuth.nhs.uk

Abstract

Background Unplanned readmissions to hospital are used in many healthcare systems as a quality indicator of care. Identifying patients at risk of readmission is difficult; existing prediction tools are only moderately sensitive. Correlations exist between certain medicines and emergency readmission, but it is not known whether the association is direct or indirect.

Objectives To determine whether person-centred pharmaceutical care bundles, comprising individualised medicines information, risk management and/or support in taking medicines, might prevent unplanned readmissions by improving adherence and reducing avoidable harm from prescribed medications.

Methods We designed and implemented person-centred pharmaceutical care bundles for patients who were socially isolated and/or on high-risk medicines on one older people's medical ward for 1 year from February 2013. Another ward with similar patient demographics, service characteristics and a standard clinical pharmacy service was used as a comparator in a prospective cohort study. Readmission rates were retrospectively studied for 12 months before the intervention and during the 12-month intervention period.

Results The readmission rates for the intervention and control wards in the 12 months before the intervention were not significantly different. During the intervention period, the readmission rate was significantly lower on the intervention ward (69/418) than on the control ward (107/490; 17% vs 22%, p<0.05, z=2.05, two-sample z test for difference in proportions of unrelated samples).

Conclusions Person-centred pharmaceutical care bundles were significantly associated with reduced risk of emergency hospital readmission in this study. Further evaluation of the model is warranted.

  • CLINICAL PHARMACY
  • GERIATRIC MEDICINE
  • INDIVIDUALISED MEDICATION SURVEILLANCE
  • SOCIAL MEDICINE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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