A pharmacy discharge plan for hospitalized elderly patients—a randomized controlled trial

Abstract

Objectives: to investigate the effectiveness of a pharmacy discharge plan in elderly hospitalized patients. Design: randomized controlled trial. Subjects and settings: we randomized patients aged 75 years and older on four or more medicines who had been discharged from three acute general and one long‐stay hospital to a pharmacy intervention or usual care. Interventions: the hospital pharmacist developed discharge plans which gave details of medication and support required by the patient. A copy was given to the patient and to all relevant professionals and carers. This was followed by a domiciliary assessment by a community pharmacist. In the control group, patients were discharged from hospital following standard procedures that included a discharge letter to the general practitioner listing current medications. Outcomes: the primary outcome was re‐admission to hospital within 6 months. Secondary outcomes included the number of deaths, attendance at hospital outpatient clinics and general practice and proportion of days in hospital over the follow‐up period, together with patients’ general well‐being, satisfaction with the service and knowledge of and adherence to prescribed medication. Results: we recruited 362 patients, of whom 181 were randomized to each group. We collected hospital and general practice data on at least 91 and 72% of patients respectively at each follow‐up point and interviewed between 43 and 90% of the study subjects. There were no significant differences between the groups in the proportion of patients re‐admitted to hospital between baseline and 3 months or 3 and 6 months. There were no significant differences in any of the secondary outcomes. Conclusions: we found no evidence to suggest that the co‐ordinated hospital and community pharmacy care discharge plans in elderly patients in this study influence outcomes.