Background Within the programmes of continuous care of the complex chronic patient (CCP), there are initiatives to improve adherence and continuity of care. Most frequent is dispensing medication upon discharge.
A discharge finite medication (FM) programme for complex chronic diseases (DMCDP) was implemented in the continuity care unit of internal medicine (UCA) in our hospital.
Purpose Evaluate the DMCDP from our hospital.
Material and methods FM is defined as drugs that the patient doesn’t have and whose estimated duration of treatment is less than 30 days.
A prospective observational study was designed with all patients classified as CCP admitted to the UCA during the first 6 months of 2018, to compare cost and number of doses dispensed (DD) between the community pharmacy (CP) system vs the DMCDP programme.
An Excel database was created. Variables: age, sex, medication dispensed, therapeutic group, indication, duration and days until end of treatment, units dispensed and saved vs CP more adjusted to treatment presentation, estimated cost in CP according to Remedios, cost of hospital dispensation and opportunity cost. All data were analysed with XLS Stat for descriptive statistics.
Tools: history of primary care, electronic prescription, medication bag, informative interview on admission and discharge, medication sheet at discharge, hourly chart, FM in unit doses with posology until the end of treatment and in daily kits dated for medications with variable posology such as descending corticoid patterns. Remedios data base.
Results Sixty-six patients were studied. Age 83 (44–98) years.
All patients had at least seven medical prescriptions: 100% of admissions were reconciled and interviewed on admission and discharge.
Thirty-four (47.2%) patients required FM according to discharge medical prescription to finish initiated hospital treatments for anticoagulation (78%), respiratory infection (ABR) (14%), urinary infection (3%), other infections (4%) and hepatic encephalopathy (1%).
Medication DD avoided were: systemic corticosteroids (59.3%), antibacterial (34.7%) and antithrombotic antihaemorragic (4.7%).
Cost savings in medication for the national health system (88.27%). Pathologies’ greatest savings were AC (78%) and ABR(14%).
The biggest problem on admission and discharge was lack of time.
Conclusion A discharge medication programme led by a hospital pharmacist, reinforces understanding and compliance for each patient, decreases the risk failure due to lack of adherence, knowledge or accessibility problems. In addition, it promotes rational use, since dispensing of the exact units reduces the possibility of future self-medication at home.
References and/or acknowledgements Jago-Byrne MM-C, et al. (GPI) discharge management: safer discharges and improved information. Int J Clin Pharma 2011;71:1–10. (http://statements.eahp.eu/sites/default/files/resources/GPI%204.2–4.3–4.4.pdf)
No conflict of interest.
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