| Title |
Impact of an enhanced pharmacy discharge service on prescribing appropriateness criteria: a randomised controlled trial
|
|---|---|
| Published in |
International Journal of Clinical Pharmacy, August 2015
|
| DOI | 10.1007/s11096-015-0186-0 |
| Pubmed ID | |
| Authors |
Benjamin J. Basger, Rebekah J. Moles, Timothy F. Chen |
| Abstract |
Background Older people are at increased risk of drug-related problems (DRPs) caused by inappropriate use or underuse of medications which may be increased during care transitions. Objective To examine the effects of applying a validated prescribing appropriateness criteria-set during medication review in a cohort of older (≥65 years) Australians at the time of discharge from hospital. Setting Private hospital and homes of older patients in Sydney, Australia. Methods Cognitively well English speaking patients aged 65 years or over taking five or more medications were recruited. A prescribing appropriateness criteria-set and SF-36 health-related quality of life health (HRQoL) survey were applied to all patients at discharge. Patients were then randomly assigned to receive either usual care (control, n = 91) or discharge medication counselling and a medication review by a clinical pharmacist (intervention, n = 92). Medication review recommendations were sent to the general practitioners of intervention group patients. All patients were followed up at 3 months post discharge, where the prescribing appropriateness criteria-set was reapplied and HRQoL survey repeated. Main outcome measures change in the number of prescribing appropriateness criteria met; change in HRQoL; number and causes of DRPS identified by medication review; intervention patient medication recommendation implementation rates. Results There was no significant difference in the number of criteria applicable and met in intervention patients, compared to control patients, between follow-up and discharge (0.09 ≤ p ≤ 0.97). While the difference between groups was positive at follow-up for SF-36 scores, the only domain that reached statistical significance was that for vitality (p = 0.04). Eighty-eight intervention patient medication reviews identified 750 causes of DRPs (8.5 ± 2.7 per patient). No causes of DRPs were identified in four patients. Of these causes, 76.4 % (573/750) were identified by application of the prescribing appropriateness criteria-set. GPs implemented a relatively low number (42.4 %, 318/750) of recommendations. Conclusion Application of a prescribing appropriateness criteria-set during medication review in intervention patients did not increase the number of criteria met, nor result in a significant improvement in HRQoL. Higher recommendation implementation rates may require additional facilitators, including a higher quality of collaboration. |
Mendeley readers
The data shown below were compiled from readership statistics for 196 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Denmark | 1 | <1% |
| Unknown | 195 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 31 | 16% |
| Researcher | 26 | 13% |
| Student > Master | 25 | 13% |
| Student > Bachelor | 20 | 10% |
| Student > Doctoral Student | 10 | 5% |
| Other | 37 | 19% |
| Unknown | 47 | 24% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 59 | 30% |
| Pharmacology, Toxicology and Pharmaceutical Science | 33 | 17% |
| Nursing and Health Professions | 16 | 8% |
| Psychology | 5 | 3% |
| Economics, Econometrics and Finance | 4 | 2% |
| Other | 22 | 11% |
| Unknown | 57 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 December 2017.
All research outputs
#7,542,164
of 23,009,818 outputs
Outputs from International Journal of Clinical Pharmacy
#468
of 1,101 outputs
Outputs of similar age
#90,446
of 266,699 outputs
Outputs of similar age from International Journal of Clinical Pharmacy
#5
of 20 outputs
Altmetric has tracked 23,009,818 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,101 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.4. This one is in the 48th percentile – i.e., 48% of its peers scored the same or lower than it.
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We're also able to compare this research output to 20 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.