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Impact of an integrated medicines management service on preventable medicines-related readmission to hospital: a descriptive study
  1. Nina L Barnett,
  2. Krupa Dave,
  3. Devinder Athwal,
  4. Paresh Parmar,
  5. Sunaina Kaher,
  6. Christine Ward
  1. London North West Healthcare NHS Trust, London, UK
  1. Correspondence to Professor Nina L Barnett, Older People, Pharmacy Department, Northwick Park Hospital, Watford Road, Harrow HA1 3AJ, UK; nina.barnett{at}nhs.net

Abstract

Background Medication contributes to 5–20% of hospital admissions, of which half are considered preventable. An integrated medicines management service (IMMS) was developed at a large general hospital in London to identify and manage patients at risk of a preventable medicines-related readmission (PMRR) to reduce the risk of PMRR.

Objective To investigate the effect of the pharmacy IMMS on the rate of PMRR within 30 days of the first discharge.

Method 744 patients were identified between October 2008 and October 2014, using the PREVENT tool. Patients at risk were managed by the IMMS with medication reconciliation, review, consultation and follow-up, as required.

Results Of 744 patients, 119 were readmitted within 30 days of discharge, with a PMRR for 2 patients (1.7%). The main reason for referral to the service was to assess the need to start a compliance aid. Most interventions involved communication: 84% included patient consultations with 50% involving discussion with the patient's community pharmacist and 32% with their general practitioner surgery.

Conclusions An IMMS may be an effective method of reducing the rate of PMRR. Further work is needed to establish the cost-effectiveness of the service.

  • medicine safety
  • medicines optimisation
  • readmissions
  • pharmacy interventions
  • discharge planning

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