Evaluation of Home-Based Follow-Up of High-Risk Elderly Patients Discharged from Hospital

Mark Naunton, Gregory M. Peterson

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Objective: To evaluate pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital. Method: A randomised controlled study, in which medical patients admitted to hospital and fulfilling high-risk criteria (including age 60 years or older and prescribed four or more regular medications) were randomly assigned to an intervention or control group. Patients in the intervention group were visited at home by a pharmacist five days after discharge. The pharmacist educated patients on their medications, encouraged compliance, assessed for drug-related problems, intervened when appropriate and communicated all relevant findings to community health professionals. The intervention group patients were revisited at home 90 days after discharge to evaluate the outcomes of interventions made on day 5. Patients in the control group were visited at home by a pharmacist 90 days after discharge and provided with an identical comprehensive medication review Results: One hundred and twenty-one patients completed the study. There were no significant differences between the two groups in key clinical and demographic parameters at baseline. A median of three drug-related problems were identified in each intervention group patient at the five day home visit. Ninety days after discharge this had declined to one, compared to two for the control group patients (p < 0.0001). In the intervention group, compliance had improved and was significantly higher than for the control group after 90 days (p < 0.0001). There was a significant decline in the use of nonsteroidal anti-inflammatory drugs by the intervention group patients. Forty-five per cent of the control group patients had unplanned readmissions to hospital during the 90 days following discharge compared to 28% of the intervention group patients (p = 0.05). The intervention program was well-received by patients and their general practitioners. Recommendations from the pharmacist were implemented by general practitioners in 79% of cases. Conclusion: A pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital is valuable in identifying and addressing drug-related problems and reducing the risk of readmission to hospital.

Original languageEnglish
Pages (from-to)176-182
Number of pages7
JournalJournal of Pharmacy Practice and Research
Volume33
Issue number3
DOIs
Publication statusPublished - 2003
Externally publishedYes

Fingerprint

Pharmacists
Pharmaceutical Preparations
Control Groups
Patient Readmission
Anti-Inflammatory Agents
Health
General Practitioners
House Calls
Medication Adherence
Compliance
Demography

Cite this

@article{07ea94b87bc94264be08fb9ea2dc2178,
title = "Evaluation of Home-Based Follow-Up of High-Risk Elderly Patients Discharged from Hospital",
abstract = "Objective: To evaluate pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital. Method: A randomised controlled study, in which medical patients admitted to hospital and fulfilling high-risk criteria (including age 60 years or older and prescribed four or more regular medications) were randomly assigned to an intervention or control group. Patients in the intervention group were visited at home by a pharmacist five days after discharge. The pharmacist educated patients on their medications, encouraged compliance, assessed for drug-related problems, intervened when appropriate and communicated all relevant findings to community health professionals. The intervention group patients were revisited at home 90 days after discharge to evaluate the outcomes of interventions made on day 5. Patients in the control group were visited at home by a pharmacist 90 days after discharge and provided with an identical comprehensive medication review Results: One hundred and twenty-one patients completed the study. There were no significant differences between the two groups in key clinical and demographic parameters at baseline. A median of three drug-related problems were identified in each intervention group patient at the five day home visit. Ninety days after discharge this had declined to one, compared to two for the control group patients (p < 0.0001). In the intervention group, compliance had improved and was significantly higher than for the control group after 90 days (p < 0.0001). There was a significant decline in the use of nonsteroidal anti-inflammatory drugs by the intervention group patients. Forty-five per cent of the control group patients had unplanned readmissions to hospital during the 90 days following discharge compared to 28{\%} of the intervention group patients (p = 0.05). The intervention program was well-received by patients and their general practitioners. Recommendations from the pharmacist were implemented by general practitioners in 79{\%} of cases. Conclusion: A pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital is valuable in identifying and addressing drug-related problems and reducing the risk of readmission to hospital.",
author = "Mark Naunton and Peterson, {Gregory M.}",
year = "2003",
doi = "10.1002/jppr2003333176",
language = "English",
volume = "33",
pages = "176--182",
journal = "Australian Journal of Hospital Pharmacy",
issn = "0310-6810",
publisher = "Wiley-Blackwell",
number = "3",

}

Evaluation of Home-Based Follow-Up of High-Risk Elderly Patients Discharged from Hospital. / Naunton, Mark; Peterson, Gregory M.

In: Journal of Pharmacy Practice and Research, Vol. 33, No. 3, 2003, p. 176-182.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Evaluation of Home-Based Follow-Up of High-Risk Elderly Patients Discharged from Hospital

AU - Naunton, Mark

AU - Peterson, Gregory M.

PY - 2003

Y1 - 2003

N2 - Objective: To evaluate pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital. Method: A randomised controlled study, in which medical patients admitted to hospital and fulfilling high-risk criteria (including age 60 years or older and prescribed four or more regular medications) were randomly assigned to an intervention or control group. Patients in the intervention group were visited at home by a pharmacist five days after discharge. The pharmacist educated patients on their medications, encouraged compliance, assessed for drug-related problems, intervened when appropriate and communicated all relevant findings to community health professionals. The intervention group patients were revisited at home 90 days after discharge to evaluate the outcomes of interventions made on day 5. Patients in the control group were visited at home by a pharmacist 90 days after discharge and provided with an identical comprehensive medication review Results: One hundred and twenty-one patients completed the study. There were no significant differences between the two groups in key clinical and demographic parameters at baseline. A median of three drug-related problems were identified in each intervention group patient at the five day home visit. Ninety days after discharge this had declined to one, compared to two for the control group patients (p < 0.0001). In the intervention group, compliance had improved and was significantly higher than for the control group after 90 days (p < 0.0001). There was a significant decline in the use of nonsteroidal anti-inflammatory drugs by the intervention group patients. Forty-five per cent of the control group patients had unplanned readmissions to hospital during the 90 days following discharge compared to 28% of the intervention group patients (p = 0.05). The intervention program was well-received by patients and their general practitioners. Recommendations from the pharmacist were implemented by general practitioners in 79% of cases. Conclusion: A pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital is valuable in identifying and addressing drug-related problems and reducing the risk of readmission to hospital.

AB - Objective: To evaluate pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital. Method: A randomised controlled study, in which medical patients admitted to hospital and fulfilling high-risk criteria (including age 60 years or older and prescribed four or more regular medications) were randomly assigned to an intervention or control group. Patients in the intervention group were visited at home by a pharmacist five days after discharge. The pharmacist educated patients on their medications, encouraged compliance, assessed for drug-related problems, intervened when appropriate and communicated all relevant findings to community health professionals. The intervention group patients were revisited at home 90 days after discharge to evaluate the outcomes of interventions made on day 5. Patients in the control group were visited at home by a pharmacist 90 days after discharge and provided with an identical comprehensive medication review Results: One hundred and twenty-one patients completed the study. There were no significant differences between the two groups in key clinical and demographic parameters at baseline. A median of three drug-related problems were identified in each intervention group patient at the five day home visit. Ninety days after discharge this had declined to one, compared to two for the control group patients (p < 0.0001). In the intervention group, compliance had improved and was significantly higher than for the control group after 90 days (p < 0.0001). There was a significant decline in the use of nonsteroidal anti-inflammatory drugs by the intervention group patients. Forty-five per cent of the control group patients had unplanned readmissions to hospital during the 90 days following discharge compared to 28% of the intervention group patients (p = 0.05). The intervention program was well-received by patients and their general practitioners. Recommendations from the pharmacist were implemented by general practitioners in 79% of cases. Conclusion: A pharmacist-conducted follow-up at home of high-risk elderly patients discharged from hospital is valuable in identifying and addressing drug-related problems and reducing the risk of readmission to hospital.

UR - http://www.scopus.com/inward/record.url?scp=0344307368&partnerID=8YFLogxK

U2 - 10.1002/jppr2003333176

DO - 10.1002/jppr2003333176

M3 - Article

VL - 33

SP - 176

EP - 182

JO - Australian Journal of Hospital Pharmacy

JF - Australian Journal of Hospital Pharmacy

SN - 0310-6810

IS - 3

ER -