Effect of a medicines management model on medication-related readmissions in older patients admitted to a medical acute admission unit

A randomized controlled trial

Trine Graabaek, Ulla Hedegaard, Mikkel B Christensen, Marianne H Clemmensen, Torben Knudsen, Lise Aagaard

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalJournal of Evaluation in Clinical Practice Online
Volume25
Issue number1
Pages (from-to)88-96
ISSN1365-2753
DOIs
Publication statusPublished - Feb 2019

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Randomized Controlled Trials
Pharmacists
Inpatients
Interviews
Patient Admission
Counseling
Outcome Assessment (Health Care)
Physicians
Control Groups

Cite this

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title = "Effect of a medicines management model on medication-related readmissions in older patients admitted to a medical acute admission unit: A randomized controlled trial",
abstract = "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.",
author = "Trine Graabaek and Ulla Hedegaard and Christensen, {Mikkel B} and Clemmensen, {Marianne H} and Torben Knudsen and Lise Aagaard",
note = "{\circledC} 2018 John Wiley & Sons, Ltd.",
year = "2019",
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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. / Graabaek, Trine; Hedegaard, Ulla; Christensen, Mikkel B; Clemmensen, Marianne H; Knudsen, Torben; Aagaard, Lise.

In: Journal of Evaluation in Clinical Practice Online, Vol. 25, No. 1, 02.2019, p. 88-96.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Effect of a medicines management model on medication-related readmissions in older patients admitted to a medical acute admission unit

T2 - A randomized controlled trial

AU - Graabaek, Trine

AU - Hedegaard, Ulla

AU - Christensen, Mikkel B

AU - Clemmensen, Marianne H

AU - Knudsen, Torben

AU - Aagaard, Lise

N1 - © 2018 John Wiley & Sons, Ltd.

PY - 2019/2

Y1 - 2019/2

N2 - 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.

AB - 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.

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DO - 10.1111/jep.13013

M3 - Journal article

VL - 25

SP - 88

EP - 96

JO - Journal of Evaluation in Clinical Practice Online

JF - Journal of Evaluation in Clinical Practice Online

SN - 1365-2753

IS - 1

ER -