Pharmacist-led medication reconciliation at patient discharge: a tool to reduce healthcare utilization? an observational study in patients 65 years or older
Abstract Background Older patients often experience adverse drug events (ADEs) after discharge that may lead to unplanned readmission. Medication Reconciliation (MR) reduces medication errors that lead to ADEs, but results on healthcare utilization are still controversial. This study aimed to assess...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-07-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-022-03192-3 |
| _version_ | 1818474538337304576 |
|---|---|
| author | Emma Bajeux Lilian Alix Lucie Cornée Camille Barbazan Marion Mercerolle Jennifer Howlett Vincent Cruveilhier Charlotte Liné-Iehl Bérangère Cador Patrick Jego Vincent Gicquel François-Xavier Schweyer Vanessa Marie Stéphanie Hamonic Jean-Michel Josselin Dominique Somme Benoit Hue |
| author_facet | Emma Bajeux Lilian Alix Lucie Cornée Camille Barbazan Marion Mercerolle Jennifer Howlett Vincent Cruveilhier Charlotte Liné-Iehl Bérangère Cador Patrick Jego Vincent Gicquel François-Xavier Schweyer Vanessa Marie Stéphanie Hamonic Jean-Michel Josselin Dominique Somme Benoit Hue |
| author_sort | Emma Bajeux |
| collection | DOAJ |
| description | Abstract Background Older patients often experience adverse drug events (ADEs) after discharge that may lead to unplanned readmission. Medication Reconciliation (MR) reduces medication errors that lead to ADEs, but results on healthcare utilization are still controversial. This study aimed to assess the effect of MR at discharge (MRd) provided to patients aged over 65 on their unplanned rehospitalization within 30 days and on both patients’ experience of discharge and their knowledge of their medication. Methods An observational multicenter prospective study was conducted in 5 hospitals in Brittany, France. Results Patients who received both MR on admission (MRa) and MRd did not have significantly fewer deaths, unplanned rehospitalizations and/or emergency visits related to ADEs (OR = 1.6 [0.7 to 3.6]) or whatever the cause (p = 0.960) 30 days after discharge than patients receiving MRa alone. However, patients receiving both MRa and MRd were more likely to feel that their discharge from the hospital was well organized (p = 0.003) and reported more frequently that their community pharmacist received information about their hospital stay (p = 0.036). Conclusions This study found no effect of MRd on healthcare utilization 30 days after discharge in patients over 65, but the process improved patients’ experiences of care continuity. Further studies are needed to better understand this positive impact on their drug care pathway in order to improve patients’ ownership of their drugs, which is still insufficient. Improving both the interview step between pharmacist and patient before discharge and the transmission of information from the hospital to primary care professionals is needed to enhance MR effectiveness. Trial registration NCT04018781 July 15, 2019. |
| first_indexed | 2024-04-14T04:38:31Z |
| format | Article |
| id | doaj.art-e2796f3a3fc441999256fe743153d025 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-14T04:38:31Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-e2796f3a3fc441999256fe743153d0252022-12-22T02:11:47ZengBMCBMC Geriatrics1471-23182022-07-0122111310.1186/s12877-022-03192-3Pharmacist-led medication reconciliation at patient discharge: a tool to reduce healthcare utilization? an observational study in patients 65 years or olderEmma Bajeux0Lilian Alix1Lucie Cornée2Camille Barbazan3Marion Mercerolle4Jennifer Howlett5Vincent Cruveilhier6Charlotte Liné-Iehl7Bérangère Cador8Patrick Jego9Vincent Gicquel10François-Xavier Schweyer11Vanessa Marie12Stéphanie Hamonic13Jean-Michel Josselin14Dominique Somme15Benoit Hue16Department of Epidemiology and Public Health, Univ Rennes, Rennes University HospitalDepartment of Internal Medicine and Clinical Immunology, Univ Rennes, Rennes University HospitalDepartment of Geriatrics, St-Laurent Polyclinic, Hospitalité St-Thomas de VilleneuveDepartment of Pharmacy, Rennes University HospitalDepartment of Pharmacy, Rennes University HospitalDepartment of Pharmacy, Rennes University HospitalDepartment of Pharmacy, Fougères HospitalDepartment of Pharmacy, Montfort/Meu HospitalDepartment of Internal Medicine and Clinical Immunology, Univ Rennes, Rennes University HospitalDepartment of Internal Medicine and Clinical Immunology, Univ Rennes, Rennes University HospitalDepartment of Pharmacy, Rennes University HospitalDepartment of Human and Social Sciences, Univ Rennes, EHESPFrance Asso SantéDepartment of Epidemiology and Public Health, Univ Rennes, Rennes University HospitalUniv Rennes, CNRSDepartment of Geriatrics, Department of Geriatrics, Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309Department of Pharmacy, Rennes University HospitalAbstract Background Older patients often experience adverse drug events (ADEs) after discharge that may lead to unplanned readmission. Medication Reconciliation (MR) reduces medication errors that lead to ADEs, but results on healthcare utilization are still controversial. This study aimed to assess the effect of MR at discharge (MRd) provided to patients aged over 65 on their unplanned rehospitalization within 30 days and on both patients’ experience of discharge and their knowledge of their medication. Methods An observational multicenter prospective study was conducted in 5 hospitals in Brittany, France. Results Patients who received both MR on admission (MRa) and MRd did not have significantly fewer deaths, unplanned rehospitalizations and/or emergency visits related to ADEs (OR = 1.6 [0.7 to 3.6]) or whatever the cause (p = 0.960) 30 days after discharge than patients receiving MRa alone. However, patients receiving both MRa and MRd were more likely to feel that their discharge from the hospital was well organized (p = 0.003) and reported more frequently that their community pharmacist received information about their hospital stay (p = 0.036). Conclusions This study found no effect of MRd on healthcare utilization 30 days after discharge in patients over 65, but the process improved patients’ experiences of care continuity. Further studies are needed to better understand this positive impact on their drug care pathway in order to improve patients’ ownership of their drugs, which is still insufficient. Improving both the interview step between pharmacist and patient before discharge and the transmission of information from the hospital to primary care professionals is needed to enhance MR effectiveness. Trial registration NCT04018781 July 15, 2019.https://doi.org/10.1186/s12877-022-03192-3Medication ReconciliationAdverse Drug EventOlder peopleDischargeExperience |
| spellingShingle | Emma Bajeux Lilian Alix Lucie Cornée Camille Barbazan Marion Mercerolle Jennifer Howlett Vincent Cruveilhier Charlotte Liné-Iehl Bérangère Cador Patrick Jego Vincent Gicquel François-Xavier Schweyer Vanessa Marie Stéphanie Hamonic Jean-Michel Josselin Dominique Somme Benoit Hue Pharmacist-led medication reconciliation at patient discharge: a tool to reduce healthcare utilization? an observational study in patients 65 years or older BMC Geriatrics Medication Reconciliation Adverse Drug Event Older people Discharge Experience |
| title | Pharmacist-led medication reconciliation at patient discharge: a tool to reduce healthcare utilization? an observational study in patients 65 years or older |
| title_full | Pharmacist-led medication reconciliation at patient discharge: a tool to reduce healthcare utilization? an observational study in patients 65 years or older |
| title_fullStr | Pharmacist-led medication reconciliation at patient discharge: a tool to reduce healthcare utilization? an observational study in patients 65 years or older |
| title_full_unstemmed | Pharmacist-led medication reconciliation at patient discharge: a tool to reduce healthcare utilization? an observational study in patients 65 years or older |
| title_short | Pharmacist-led medication reconciliation at patient discharge: a tool to reduce healthcare utilization? an observational study in patients 65 years or older |
| title_sort | pharmacist led medication reconciliation at patient discharge a tool to reduce healthcare utilization an observational study in patients 65 years or older |
| topic | Medication Reconciliation Adverse Drug Event Older people Discharge Experience |
| url | https://doi.org/10.1186/s12877-022-03192-3 |
| work_keys_str_mv | AT emmabajeux pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT lilianalix pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT luciecornee pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT camillebarbazan pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT marionmercerolle pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT jenniferhowlett pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT vincentcruveilhier pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT charlottelineiehl pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT berangerecador pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT patrickjego pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT vincentgicquel pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT francoisxavierschweyer pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT vanessamarie pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT stephaniehamonic pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT jeanmicheljosselin pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT dominiquesomme pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder AT benoithue pharmacistledmedicationreconciliationatpatientdischargeatooltoreducehealthcareutilizationanobservationalstudyinpatients65yearsorolder |