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Timeliness and Clinical Impact of Hospital‐Initiated Medication Reviews
Author(s) -
Lövgren Suzanna,
Clark Robyn A,
Angley Manya,
Ponniah Anne P,
Colley Desmond,
Shakib Sepehr
Publication year - 2009
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2009.tb00472.x
Subject(s) - medicine , bespoke , referral , family medicine , accreditation , deprescribing , government (linguistics) , nursing , polypharmacy , medical education , intensive care medicine , linguistics , philosophy , political science , law
Background Medication‐related problems often occur in the immediate post‐discharge period. To reduce medication misadventure the Commonwealth Government funds home medicines reviews (HMRs). HMRs are initiated when general practitioners refer consenting patients to their community pharmacists, who then engage accredited pharmacists to review patients' medicines in their homes. Aim To determine if hospital‐initiated medication reviews (HIMRs) can be implemented in a more timely manner than HMRs; and to assess the impact of a bespoke referral form with comorbidity‐specific questions on the quality of reports. Method Eligible medical inpatients at risk of medication misadventure were referred by the hospital liaison pharmacist to participating accredited pharmacists post‐discharge from hospital. Social, demographic and laboratory data were collected from medical records and during interviews with consenting patients. Issues raised in the HIMR reports were categorised: intervention/action, information given or recommendation, and assigned a rank of clinical significance. Results HIMRs were conducted within 11.6 ± 6.6 days post‐discharge. 36 HIMR reports were evaluated and 1442 issues identified – information given (n = 1204), recommendations made (n = 88) and actions taken (n = 150). The majority of issues raised (89%) had a minor clinical impact. The bespoke referral form prompted approximately half of the issues raised. Conclusion HIMRs can be facilitated in a more timely manner than post‐discharge HMRs. There was an associated positive clinical impact of issues raised in the HIMR reports.