A medicine optimisation clinic (MOC) by hospital pharmacists two weeks’ post-discharge reduced the rate of unplanned readmissions in a new pilot study by a team from the School of Pharmacy, Queen’s University, Belfast.
In this randomised pilot trial, the researchers sought to assess the impact of a pharmacist-led MOC on both patient and healthcare system outcomes, compared with standard practice, that is, the normal post-discharge care advice. The MOC targeted patients at a high risk of medicine-problems after being in hospital and involved the provision of a comprehensive medicine review together with educational and lifestyle advice, for example, smoking cessation, where appropriate.
The primary outcome was the 30-day unplanned readmission to hospital although the researchers also explored readmissions over a longer period, out-of-hours (OOH) GP and emergency department (ED) visits and several patient-related quality of life measures.
In total 62 patients were randomised to the MOC or standard care. Using an intention-to-treat analysis, the 30-day readmission rate for the intervention group was 6.5% vs 16.1% control group (p = 0.42) and the benefit-cost ratio 20.72 vs 21.85 (intervention vs control group). Greater improvements in patient-related quality of life metrics and fewer OOH GP and ED visits also occurred in the intervention group.
The authors called for a larger study to more clearly define the patient benefits from this novel intervention.
Reference
Odeh M et al. A novel approach to medicines optimisation post-discharge from hospital: pharmacist-led medicines optimisation clinic. Int J Clin Pharm 2020; Jun 11 doi: 10.1007/s11096-020-01059-4.
