OBJECTIVE: This study aimed to determine whether pharmacist-provided home-based medication review (HBMR) can reduce readmissions in the elderly. DESIGN: Retrospective cohort study. SETTING: Patient's home. PARTICIPANTS: Records of patients referred to a care transition program from March 2011 through March 2015 were reviewed. Patients aged 60 years and older taking more than 5 medications and had at least 2 unplanned admissions within 3 months preceding the first home visit were included. INTERVENTION: Pharmacist-provided HBMR. MAIN OUTCOME MEASURES: Primary outcome was readmission rate over 6 months after the first home visit. Secondary outcomes included emergency department (ED) visits, outpatient visits and mortality. Drug-related problems (DRPs) were reported for the HBMR group. Multivariate incidence rate ratios (IRR) and hazard ratio (HR) were calculated with adjustments for covariates. RESULTS: The study included 499 patients (97 HBMR, 402 no HBMR). Pharmacist-provided HBMR reduced readmissions by 26% (IRR = 0.74, 95% CI: 0.59-0.92, P = 0.007), reduced ED visits by 20% (IRR = 0.80, 95% CI: 0.66-0.98, P = 0.030) and increased outpatient visits by 16% (IRR = 1.16, 95% CI: 0.95-1.41, P = 0.150). There were 8 and 44 deaths in the HBMR and no HBMR groups respectively (HR = 0.73, 95% CI: 0.29-1.81, P = 0.492). Pharmacists identified 464 DRPs, with 169 (36.4%) resolved within 1 month after the home visit. CONCLUSIONS: The study suggests that pharmacist-provided HBMR is effective in reducing readmissions and ED visits in the elderly. More studies in the Asian population are needed to determine its long term benefits and patient's acceptability.
OBJECTIVE: This study aimed to determine whether pharmacist-provided home-based medication review (HBMR) can reduce readmissions in the elderly. DESIGN: Retrospective cohort study. SETTING: Patient's home. PARTICIPANTS: Records of patients referred to a care transition program from March 2011 through March 2015 were reviewed. Patients aged 60 years and older taking more than 5 medications and had at least 2 unplanned admissions within 3 months preceding the first home visit were included. INTERVENTION: Pharmacist-provided HBMR. MAIN OUTCOME MEASURES: Primary outcome was readmission rate over 6 months after the first home visit. Secondary outcomes included emergency department (ED) visits, outpatient visits and mortality. Drug-related problems (DRPs) were reported for the HBMR group. Multivariate incidence rate ratios (IRR) and hazard ratio (HR) were calculated with adjustments for covariates. RESULTS: The study included 499 patients (97 HBMR, 402 no HBMR). Pharmacist-provided HBMR reduced readmissions by 26% (IRR = 0.74, 95% CI: 0.59-0.92, P = 0.007), reduced ED visits by 20% (IRR = 0.80, 95% CI: 0.66-0.98, P = 0.030) and increased outpatient visits by 16% (IRR = 1.16, 95% CI: 0.95-1.41, P = 0.150). There were 8 and 44 deaths in the HBMR and no HBMR groups respectively (HR = 0.73, 95% CI: 0.29-1.81, P = 0.492). Pharmacists identified 464 DRPs, with 169 (36.4%) resolved within 1 month after the home visit. CONCLUSIONS: The study suggests that pharmacist-provided HBMR is effective in reducing readmissions and ED visits in the elderly. More studies in the Asian population are needed to determine its long term benefits and patient's acceptability.
Authors: Samuel Kabue; John Greene; Patricia Kipnis; Brian Lawson; Gina Rinetti-Vargas; Vincent Liu; Gabriel Escobar Journal: Med Care Date: 2019-04 Impact factor: 2.983
Authors: Ashley M Campbell; Kim C Coley; Jason M Corbo; Teresa M DeLellis; Matthew Joseph; Carolyn T Thorpe; Melissa S McGivney; Patricia Klatt; Lora Cox-Vance; Vincent Balestrino; Heather Sakely Journal: Am Health Drug Benefits Date: 2018-12
Authors: Kelly L Hayward; Preya J Patel; Patricia C Valery; Leigh U Horsfall; Catherine Y Li; Penny L Wright; Caroline J Tallis; Katherine A Stuart; Katharine M Irvine; W Neil Cottrell; Jennifer H Martin; Elizabeth E Powell Journal: Hepatol Commun Date: 2019-03-18
Authors: A E M J H Linkens; V Milosevic; P H M van der Kuy; V H Damen-Hendriks; C Mestres Gonzalvo; K P G M Hurkens Journal: Int J Clin Pharm Date: 2020-05-30
Authors: Aimée E M J H Linkens; Vanja Milosevic; Noémi van Nie; Anne Zwietering; Peter W de Leeuw; Marjan van den Akker; Jos M G A Schols; Silvia M A A Evers; Carlota Mestres Gonzalvo; Bjorn Winkens; Bob P A van de Loo; Louis de Wolf; Lucretia Peeters; Monique de Ree; Bart Spaetgens; Kim P G M Hurkens; Hugo M van der Kuy Journal: BMC Geriatr Date: 2022-01-10 Impact factor: 3.921
Authors: M Rozaini Rosli; Chin F Neoh; David B Wu; Nazariah W Hassan; Mahani Mahmud; Afifah Rahimi; Mahmathi Karuppannan Journal: Pharm Pract (Granada) Date: 2021-09-09
Authors: Andrea Lázaro Cebas; José Manuel Caro Teller; Carmen García Muñoz; Carlos González Gómez; José Miguel Ferrari Piquero; Carlos Lumbreras Bermejo; José Antonio Romero Garrido; Juana Benedí González Journal: BMC Health Serv Res Date: 2022-02-09 Impact factor: 2.655