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Effect of a medicines management model on medication‐related readmissions in older patients admitted to a medical acute admission unit—A randomized controlled trial
Author(s) -
Graabæk Trine,
Hedegaard Ulla,
Christensen Mikkel B.,
Clemmensen Marianne H.,
Knudsen Torben,
Aagaard Lise
Publication year - 2019
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.13013
Subject(s) - medicine , pharmacist , randomized controlled trial , medication therapy management , emergency medicine , intervention (counseling) , adverse effect , clinical pharmacy , pharmacy , family medicine , psychiatry
Rationale, aims, and objectives Medication‐related problems are frequent and can lead to serious adverse events resulting in increased morbidity, mortality, and costs. Medication use in frail older patients is even more complex. The aim of this study was to investigate the effect of a pharmacist‐led medicines management model among older patients at admission, during inpatient stay and at discharge on medication‐related readmissions. Method A randomized controlled trial conducted at the acute admission unit in a Danish hospital with acutely admitted medical patients, randomized to either a control group or one of two intervention groups. The intervention consisted of pharmacist‐led medication review and patient interview upon admission (intervention ED) or pharmacist‐led medication review and patient interview upon admission, medication review during inpatient stay, and medication report and patient counselling at discharge (intervention STAY). Results In total, 600 patients were included. The pharmacist identified 920 medication‐related problems with 57% of the recommendations accepted by the physician. After 30 days, 25 patients had a medication‐related readmission, with no statistical significant difference between the groups on either primary or secondary outcomes. Conclusions This study showed that a clinical pharmacist can be used to identify and solve medication‐related problems, but this study did not find any effect on the selected outcomes. The frequency of medication‐related readmissions was low, leaving little room for improvement. Future research should consider other study designs or outcome measures.