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Evaluation of home-based follow-up of high-risk elderly patients discharged from hospital

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Naunton, M and Peterson, GM, Evaluation of home-based follow-up of high-risk elderly patients discharged from hospital, Journal of Pharmacy Practice and Research, 33, (3) pp. 176-182. ISSN 1445-937X (2003) [Refereed Article]


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Copyright Statement

Copyright 2006 The Society of Hospital Pharmacists of Australia

Official URL: http://www.shpa.org.au/scripts/cgiip.exe/WService=...

Abstract

Objective: To evaluate pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital.

Method: A randomised controlled study, in which medical patients admitted to hospital and fulfilling high-risk criteria (including age 60 years or older and prescribed four or more regular medications) were randomly assigned to an intervention or control group. Patients in the intervention group were visited at home by a pharmacist five days after discharge. The pharmacist educated patients on their medications, encouraged compliance, assessed for drug-related problems, intervened when appropriate and communicated all relevant findings to community health professionals. The intervention group patients were revisited at home 90 days after discharge to evaluate the outcomes of interventions made on day 5. Patients in the control group were visited at home by a pharmacist 90 days after discharge and provided with an identical comprehensive medication review.

Results: One hundred and twenty-one patients completed the study. There were no significant differences between the two groups in key clinical and demographic parameters at baseline. A median of three drug-related problems were identified in each intervention group patient at the five day home visit. Ninety days after discharge this had declined to one, compared to two for the control group patients (p < 0.0001). In the intervention group, compliance had improved and was significantly higher than for the control group after 90 days (p < 0.0001). There was a significant decline in the use of nonsteroidal anti-inflammatory drugs by the intervention group patients. Forty-five per cent of the control group patients had unplanned readmissions to hospital during the 90 days following discharge compared to 28% of the intervention group patients (p = 0.05). The intervention program was well-received by patients and their general practitioners. Recommendations from the pharmacist were implemented by general practitioners in 79% of cases.

Conclusion: A pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital is valuable in identifying and addressing drug-related problems and reducing the risk of readmission to hospital.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Public Health and Health Services not elsewhere classified
Objective Division:Health
Objective Group:Specific Population Health (excl. Indigenous Health)
Objective Field:Health Related to Ageing
Author:Naunton, M (Mr Mark Naunton)
Author:Peterson, GM (Professor Gregory Peterson)
ID Code:28447
Year Published:2003
Deposited By:Pharmacy
Deposited On:2003-08-01
Last Modified:2014-10-15
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