Skip to main content
Top
Published in: International Journal of Clinical Pharmacy 5/2019

Open Access 01-10-2019 | Care | Research Article

Evaluating the Connect with Pharmacy web-based intervention to reduce hospital readmission for older people

Authors: Fatima R. N. Sabir, Justine Tomlinson, Barry Strickland-Hodge, Heather Smith

Published in: International Journal of Clinical Pharmacy | Issue 5/2019

Login to get access

Abstract

Background The patient transition from a hospital to a post-discharge healthcare setting has potential to disrupt continuity of medication management and increase the risk of harm. “Connect with Pharmacy” is a new electronic web-based transfer of care initiative employed by Leeds Teaching Hospitals NHS Trust. This allows the sharing of discharge information between the hospital and a patient’s chosen community pharmacy. Objective We investigated whether the timely sharing of discharge information with community pharmacies via “Connect with Pharmacy” reduced hospital readmission rates in older patients. Method To evaluate intervention efficacy, hospital admission data was retrospectively collected. For primary analysis, admission rates were tracked 6-months prior (baseline) and 6-months post-intervention. Secondary measures included effect on total length of stay if readmitted, emergency department attendance and duration, and impact of polypharmacy. Main outcome measure The rate of non-elective hospital readmissions, 6-months post-intervention. Results In the sample (n = 627 patients; Mean age = 81 years), emergency readmission rates following the intervention (M = 1.1, 95% CI [0.98, 1.22]) reduced by 16.16% relative to baseline (M = 1.31, 95% CI [1.21, 1.42]) (W = 54,725; p < 0.001). There was no reduction in total length of stay. Subsidiary analysis revealed a post-intervention reduction in number of days spent in hospital lasting more than three days (χ2 = 13.37, df = 1, p < 0 .001). There were no statistically reliable differences in the remaining secondary measures. Conclusion The results showed a reduction in readmissions and potential post-intervention length of stay, indicating there may be further benefits for our older patients’ experiences and hospital flow.
Literature
1.
go back to reference Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007;297(8):831–41.CrossRef Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007;297(8):831–41.CrossRef
2.
go back to reference Witherington EMA, Pirzada OM, Avery AJ. Communication gaps and readmissions to hospital for patients aged 75 years and older: observational study. Qual Saf Health Care. 2008;17(1):71–5.CrossRef Witherington EMA, Pirzada OM, Avery AJ. Communication gaps and readmissions to hospital for patients aged 75 years and older: observational study. Qual Saf Health Care. 2008;17(1):71–5.CrossRef
4.
go back to reference Dvorak SR, McCoy RA, Voss GD. Continuity of care from acute to ambulatory care setting. Am J Health Syst Pharm. 1998;55(23):2500.CrossRef Dvorak SR, McCoy RA, Voss GD. Continuity of care from acute to ambulatory care setting. Am J Health Syst Pharm. 1998;55(23):2500.CrossRef
5.
go back to reference Chen Y, Brennan N, Magrabi F. Is email an effective method for hospital discharge communication? A randomized controlled trial to examine delivery of computer-generated discharge summaries by email, fax, post and patient hand delivery. Int J Med Inform. 2010;79(3):167–72.CrossRef Chen Y, Brennan N, Magrabi F. Is email an effective method for hospital discharge communication? A randomized controlled trial to examine delivery of computer-generated discharge summaries by email, fax, post and patient hand delivery. Int J Med Inform. 2010;79(3):167–72.CrossRef
6.
go back to reference Spencer RA, Spencer SEF, Rodgers S, Campbell SM, Avery AJ. Processing of discharge summaries in general practice: a retrospective record review. Br J Gen Pract. 2018;68(673):576–85.CrossRef Spencer RA, Spencer SEF, Rodgers S, Campbell SM, Avery AJ. Processing of discharge summaries in general practice: a retrospective record review. Br J Gen Pract. 2018;68(673):576–85.CrossRef
8.
go back to reference Parekh N, Ali K, Stevenson JM, Davies JG, Schiff R, Van der Cammen T, et al. Incidence and cost of medication harm in older adults following hospital discharge: a multicentre prospective study in the UK. Br J Clin Pharmacol. 2018;84(8):1789–97.CrossRef Parekh N, Ali K, Stevenson JM, Davies JG, Schiff R, Van der Cammen T, et al. Incidence and cost of medication harm in older adults following hospital discharge: a multicentre prospective study in the UK. Br J Clin Pharmacol. 2018;84(8):1789–97.CrossRef
9.
go back to reference Paulino EI, Bouvy ML, Gastelurrutia MA, Guerreiro M, Buurma H. Drug related problems identified by European community pharmacists in patients discharged from hospital. Pharm World Sci. 2004;26(6):353–60.PubMed Paulino EI, Bouvy ML, Gastelurrutia MA, Guerreiro M, Buurma H. Drug related problems identified by European community pharmacists in patients discharged from hospital. Pharm World Sci. 2004;26(6):353–60.PubMed
10.
go back to reference Ahmad A, Mast MR, Nijpels G, Elders PJ, Dekker JM, Hugtenburg JG. Identification of drug-related problems of elderly patients discharged from hospital. Patient Prefer Adherence. 2014;8:155–65.PubMedPubMedCentral Ahmad A, Mast MR, Nijpels G, Elders PJ, Dekker JM, Hugtenburg JG. Identification of drug-related problems of elderly patients discharged from hospital. Patient Prefer Adherence. 2014;8:155–65.PubMedPubMedCentral
11.
go back to reference Coleman EA, Smith JD, Raha D, Min S. Posthospital medication discrepancies: prevalence and contributing factors. Arch Intern Med. 2005;165(16):1842–7.CrossRef Coleman EA, Smith JD, Raha D, Min S. Posthospital medication discrepancies: prevalence and contributing factors. Arch Intern Med. 2005;165(16):1842–7.CrossRef
12.
go back to reference Himmel W, Kochen M, Sorns U, Hummers-Pradier E. Drug changes at the interface between primary and secondary care. Int J Clin Pharmacol Ther. 2004;42(2):103–9.CrossRef Himmel W, Kochen M, Sorns U, Hummers-Pradier E. Drug changes at the interface between primary and secondary care. Int J Clin Pharmacol Ther. 2004;42(2):103–9.CrossRef
13.
go back to reference Thompson-Moore N, Liebl MG. Health care system vulnerabilities: Understanding the root causes of patient harm. Am J Health Syst Pharm. 2012;69(5):431–6.CrossRef Thompson-Moore N, Liebl MG. Health care system vulnerabilities: Understanding the root causes of patient harm. Am J Health Syst Pharm. 2012;69(5):431–6.CrossRef
14.
go back to reference Vira T, Colquhoun M, Etchells E. Reconcilable differences: correcting medication errors at hospital admission and discharge. Qual Saf Health Care. 2006;15(2):122.CrossRef Vira T, Colquhoun M, Etchells E. Reconcilable differences: correcting medication errors at hospital admission and discharge. Qual Saf Health Care. 2006;15(2):122.CrossRef
15.
go back to reference Jasinarachchi KH, Ibrahim IR, Keegan BC, Mathialagan R, McGourty JC, Phillips JR, et al. Delayed transfer of care from NHS secondary care to primary care in England: its determinants, effect on hospital bed days, prevalence of acute medical conditions and deaths during delay, in older adults aged 65 years and over. BMC Geriatr. 2009;9(1):4.CrossRef Jasinarachchi KH, Ibrahim IR, Keegan BC, Mathialagan R, McGourty JC, Phillips JR, et al. Delayed transfer of care from NHS secondary care to primary care in England: its determinants, effect on hospital bed days, prevalence of acute medical conditions and deaths during delay, in older adults aged 65 years and over. BMC Geriatr. 2009;9(1):4.CrossRef
16.
go back to reference Guthrie B, McCowan C, Davey P, Simpson CR, Dreischulte T, Barnett K. High risk prescribing in primary care patients particularly vulnerable to adverse drug events: cross sectional population database analysis in Scottish general practice. BMJ. 2011;342:d3514.CrossRef Guthrie B, McCowan C, Davey P, Simpson CR, Dreischulte T, Barnett K. High risk prescribing in primary care patients particularly vulnerable to adverse drug events: cross sectional population database analysis in Scottish general practice. BMJ. 2011;342:d3514.CrossRef
17.
go back to reference Arora VM, Prochaska ML, Farnan JM, D’Arcy M, Schwanz KJ, Vinci LM, et al. Problems after discharge and understanding of communication with their PCPs among hospitalized seniors: a mixed methods study. J Hosp Med. 2010;5(7):385–91.CrossRef Arora VM, Prochaska ML, Farnan JM, D’Arcy M, Schwanz KJ, Vinci LM, et al. Problems after discharge and understanding of communication with their PCPs among hospitalized seniors: a mixed methods study. J Hosp Med. 2010;5(7):385–91.CrossRef
18.
go back to reference Driscoll A. Managing post-discharge care at home: an analysis of patients’ and their carers’ perceptions of information received during their stay in hospital. J Adv Nurs. 2000;31(5):1165–73.CrossRef Driscoll A. Managing post-discharge care at home: an analysis of patients’ and their carers’ perceptions of information received during their stay in hospital. J Adv Nurs. 2000;31(5):1165–73.CrossRef
19.
go back to reference Knight DA, Thompson D, Mathie E, Dickinson A. ‘Seamless care? Just a list would have helped!’ Older people and their carer’s experiences of support with medication on discharge home from hospital. Health Expect. 2013;16(3):277–91.CrossRef Knight DA, Thompson D, Mathie E, Dickinson A. ‘Seamless care? Just a list would have helped!’ Older people and their carer’s experiences of support with medication on discharge home from hospital. Health Expect. 2013;16(3):277–91.CrossRef
20.
go back to reference Nazar H, Nazar Z, Portlock J, Todd A, Slight SP. A systematic review of the role of community pharmacies in improving the transition from secondary to primary care. Br J Clin Pharmacol. 2015;80(5):936–48.CrossRef Nazar H, Nazar Z, Portlock J, Todd A, Slight SP. A systematic review of the role of community pharmacies in improving the transition from secondary to primary care. Br J Clin Pharmacol. 2015;80(5):936–48.CrossRef
21.
go back to reference Hesselink G, Zegers M, Vernooij-Dassen M, Barach P, Kalkman C, Flink M, et al. Improving patient discharge and reducing hospital readmissions by using intervention mapping. BMC Health Serv Res. 2014;14(1):389.CrossRef Hesselink G, Zegers M, Vernooij-Dassen M, Barach P, Kalkman C, Flink M, et al. Improving patient discharge and reducing hospital readmissions by using intervention mapping. BMC Health Serv Res. 2014;14(1):389.CrossRef
22.
go back to reference Neeman M, Dobrinas M, Maurer S, Tagan D, Sautebin A, Blanc A-L, et al. Transition of care: a set of pharmaceutical interventions improves hospital discharge prescriptions from an internal medicine ward. Eur J Intern Med. 2017;38:30–7.CrossRef Neeman M, Dobrinas M, Maurer S, Tagan D, Sautebin A, Blanc A-L, et al. Transition of care: a set of pharmaceutical interventions improves hospital discharge prescriptions from an internal medicine ward. Eur J Intern Med. 2017;38:30–7.CrossRef
23.
go back to reference Breuker C, Macioce V, Mura T, Audurier Y, Boegner C, Jalabert A, et al. Medication errors at hospital admission and discharge in type 1 and 2 diabetes. Diabet Med. 2017;34(12):1742–6.CrossRef Breuker C, Macioce V, Mura T, Audurier Y, Boegner C, Jalabert A, et al. Medication errors at hospital admission and discharge in type 1 and 2 diabetes. Diabet Med. 2017;34(12):1742–6.CrossRef
24.
go back to reference Nazar H, Brice S, Akhter N, Kasim A, Gunning A, Slight SP, et al. New transfer of care initiative of electronic referral from hospital to community pharmacy in England: a formative service evaluation. BMJ Open. 2016;6(10):e012532.CrossRef Nazar H, Brice S, Akhter N, Kasim A, Gunning A, Slight SP, et al. New transfer of care initiative of electronic referral from hospital to community pharmacy in England: a formative service evaluation. BMJ Open. 2016;6(10):e012532.CrossRef
25.
go back to reference Elliott RA, Boyd MJ, Salema N-E, Davies J, Barber N, Mehta RL, et al. Supporting adherence for people starting a new medication for a long-term condition through community pharmacies: a pragmatic randomised controlled trial of the New Medicine Service. BMJ Qual Saf. 2016;25(10):747.CrossRef Elliott RA, Boyd MJ, Salema N-E, Davies J, Barber N, Mehta RL, et al. Supporting adherence for people starting a new medication for a long-term condition through community pharmacies: a pragmatic randomised controlled trial of the New Medicine Service. BMJ Qual Saf. 2016;25(10):747.CrossRef
26.
go back to reference Trueman P, Lowson K, Blighe A, Meszaros A. Evaluation of the scale, causes and costs of waste medicines. The York Health Economics Consortium and The School of Pharmacy, University of London, 2010. Trueman P, Lowson K, Blighe A, Meszaros A. Evaluation of the scale, causes and costs of waste medicines. The York Health Economics Consortium and The School of Pharmacy, University of London, 2010.
28.
go back to reference Duerden M, Avery A, Payne R. Polypharmacy and medicines optimisation: making it safe and sound. London: 2013. Duerden M, Avery A, Payne R. Polypharmacy and medicines optimisation: making it safe and sound. London: 2013.
29.
go back to reference Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230.CrossRef Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230.CrossRef
30.
go back to reference R Development Core Team. R: a language and environment for statistical computing Vienna, Austria: R Foundation for Statistical Computing; 2013. Version 3.4.1. Available from: https://www.r-project.org/. Accessed 2nd Nov 2017. R Development Core Team. R: a language and environment for statistical computing Vienna, Austria: R Foundation for Statistical Computing; 2013. Version 3.4.1. Available from: https://​www.​r-project.​org/​. Accessed 2nd Nov 2017.
31.
go back to reference Slight SP, Howard R, Ghaleb M, Barber N, Franklin BD, Avery AJ. The causes of prescribing errors in English general practices: a qualitative study. Br J Gen Pract. 2013;63(615):713–20.CrossRef Slight SP, Howard R, Ghaleb M, Barber N, Franklin BD, Avery AJ. The causes of prescribing errors in English general practices: a qualitative study. Br J Gen Pract. 2013;63(615):713–20.CrossRef
32.
go back to reference Describing deprescribing. Drug Therap Bull. 2014;52(3):25. Describing deprescribing. Drug Therap Bull. 2014;52(3):25.
Metadata
Title
Evaluating the Connect with Pharmacy web-based intervention to reduce hospital readmission for older people
Authors
Fatima R. N. Sabir
Justine Tomlinson
Barry Strickland-Hodge
Heather Smith
Publication date
01-10-2019
Publisher
Springer International Publishing
Keyword
Care
Published in
International Journal of Clinical Pharmacy / Issue 5/2019
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-019-00887-3

Other articles of this Issue 5/2019

International Journal of Clinical Pharmacy 5/2019 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.