Identifying medication-related problems in pharmacist-run home visits

Area of Science:

• Pharmacy Practice
• Patient Care
• Health Services Research

Background:

• Frequent emergency department (ED) users are high-risk patients facing medication-related problems (MRPs) and health barriers.
• Home visits (HVs) are a potential intervention for patients with complex health needs, including uncontrolled diseases or poor health literacy.

Purpose of the Study:

• To compare the effectiveness of pharmacist-led HVs versus office visits (OVs) in identifying MRPs among frequent ED users.
• To assess patient perceptions of HV services provided by pharmacists and pharmacy students.

Main Methods:

• A retrospective chart review included patients with at least two ED visits in 12 months.
• Eligible patients were randomized to either an HV group or an OV group for medication review.
• The HV group received visits from a pharmacist and students; the OV group reviewed medications in the office.

Main Results:

• Home visits identified significantly more MRPs (mean 5) than office visits (mean 3.3) (P=0.034).
• Nonadherence was the most frequent MRP, and medication reconciliation was the primary intervention.
• Patients receiving HVs reported positive experiences, viewing student pharmacists professionally and valuing the home visit service.

Conclusions:

• Patient homes provide a practical setting for pharmacists to identify MRPs and optimize medication management.
• Pharmacist-led HVs are effective in detecting medication-related issues in high-risk populations like frequent ED users.