Pharmacy Daily | GP pharmacists cut ED presentations

HAVING pharmacists integrated into general practice teams to review patients' medication use cuts emergency department (ED)presentations due to medicine-related harm, research reveals.

The Reducing Medical Admissions into Hospital through Optimising Medicines (REMAIN HOME) trial, featured 306 patients, with 177 in the control group, while 129 received a comprehensive face-to-face medicine management consultation with an integrated pharmacist within seven days of their hospital discharge, MJA InSight reported.

Research leader from the University of Queensland, Associate Professor Christopher Freeman, reported that by 12 months follow-up there have been 282 readmissions amongst the control group and 136 in the intervention population, with the difference not deemed to be statistically different.

However, Freeman noted that ED presentation and combined readmission and ED presentation incidence were significantly lower for the intervention group.

Freeman estimated that the incremental net cost benefit of the intervention was $5,072 per patient.

"The incidence of ED presentations (54% lower) and the combined incidence of hospital re-admissions and ED presentations (31% lower) were each statistically significantly lower during the intervention," he said.

"As the incidence of re-admissions was significantly lower at 30 days, additional intervention by pharmacists and GP teams may be required after the initial intervention."

Freeman added that pharmacists involved in the intervention group were able to identify poor medication adherence, which was noted as a common factor in patients being readmitted to hospital.

"GPs having additional clinical information and tacit knowledge about their patients may also be beneficial," he said.

"As the proportions of patients who saw their GP within a week of discharge were similar for both groups (about 60%), lower hospital use was probably more attributable to the consultation with the pharmacist than early GP review."