| Summary: | Nicola Harrap,1 Joshua Wells,1 Katherine Howes,2 Reem Kayyali1 1Department of Pharmacy, Kingston University, Kingston, KT1 2EE, UK; 2Lewisham Integrated Medicines Optimisation Service, Pharmacy Department, Lewisham & Greenwich NHS Trust, London, SE13 6LH, UKCorrespondence: Reem Kayyali, Department of Pharmacy, Kingston University, Penrhyn Road, Kingston, KT1 2EE, UK, Tel/Fax +44 208 417 2561, Email r.kayyali@kingston.ac.ukPurpose: Quantifying the impact of pharmacy interventions, such as tailored medicines optimisation, can be challenging owing to the sometimes-indirect nature of their effect on patient outcomes such A&E (Accident & Emergency) attendance, hospital admission and length of stay. This study aimed to assess the impact of the, Lewisham Integrated Medicines Optimisation Service (LIMOS) on medicines self-management, A&E attendances and hospital admissions.Patients and Methods: The study was conducted as a retrospective and prospective observational evaluation of patients referred to LIMOS at University Hospital Lewisham between April and September 2016. Only patients with an appropriate referral that received a LIMOS intervention within the study period were considered eligible. The main outcomes examined pre- and post-LIMOS included medicines self-management, A&E attendance, number of admissions, as well as length of stay.Results: Data were collected for a total of 193 patients. Over half (56.4%, n = 109) identified as female with a mean age of 78 years at the time of referral. The number of hospital admissions decreased significantly post-LIMOS (− 0.36 ± 1.87, 95% CI − 0.63– 0.10). Furthermore, the mean reduction in length of stay was significant and decreased by over a week (19.58 vs 11.09 days post-LIMOS, − 7.67 ± 48.57, 95% CI − 14.57–− 0.78). There was a significant increase in A&E visits observed post-intervention (0.78 ± 1.93, 95% CI 0.50– 1.06); however, the majority (63%, n =165/261) occurred over 90 days post-intervention. There was a significant reduction in the number of patients self-managing medication post-LIMOS, with the number of patients receiving additional support with their medication increasing (− 0.38 ± 0.50, 95% CI − 0.45–− 0.31). LIMOS, therefore, successfully identified patients who were unable to manage their medicines.Conclusion: Specialist pharmacy interventions, which include support with medicines management, have a positive impact on admission avoidance and length of hospital stay.Keywords: medicines optimisation, admission, medication adherence, social care, polypharmacy
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