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A pharmacy discharge plan for hospitalized elderly patients--a randomized controlled trial
I Nazareth1, A Burton, S Shulman
1Department of Primary Care and Population Sciences, Royal Free and University College Medical School, University College London, UK. i.nazareth@ucl.ac.uk
Age and Ageing
|April 27, 2001
Summary
A pharmacy discharge plan for elderly patients did not reduce hospital readmissions or improve other outcomes. This coordinated care approach showed no significant benefit over standard discharge procedures in the study.
Area of Science:
- Geriatric Medicine
- Pharmaceutical Care
- Health Services Research
Background:
- Elderly patients, particularly those on multiple medications, are at high risk for adverse health outcomes after hospital discharge.
- Effective discharge planning is crucial to ensure continuity of care and prevent complications.
Purpose of the Study:
- To evaluate the effectiveness of a coordinated pharmacy discharge plan involving hospital and community pharmacists for elderly patients.
- To determine if this intervention impacts hospital readmission rates and other patient outcomes.
Main Methods:
- A randomized controlled trial was conducted with 362 patients aged 75 years and older, taking four or more medications.
- Patients were assigned to either a comprehensive pharmacy discharge plan group or a usual care control group.
- The intervention included detailed discharge plans, patient education, and domiciliary assessment by a community pharmacist.
Main Results:
- No statistically significant difference was observed in hospital re-admission rates between the intervention and control groups within six months.
- Secondary outcomes, including mortality, clinic/GP attendance, hospital days, well-being, satisfaction, and medication adherence, also showed no significant differences.
- Data collection involved hospital records, general practice data, and patient interviews, with high participation rates.
Conclusions:
- The study found no evidence that coordinated hospital and community pharmacy discharge plans improve outcomes for elderly patients.
- Current discharge planning strategies may require re-evaluation for this high-risk population.