184 THE EFFECTS OF MEDICINE OPTIMISATION BY A CONSULTANT PHARMACIST IN A 'HOSPITAL AT HOME' SETTING

Autor: K Ryan, C Darcy, R Miller-Anderson
Rok vydání: 2022
Předmět:
Zdroj: Age and Ageing. 51
ISSN: 1468-2834
0002-0729
Popis: Background Hospital at Home is a rapidly growing initiative whereby patients are offered hospital equivalent interventions at their home. Given that patient numbers under the care of this team are often smaller than those on inpatient hospital wards, there is often more time to develop a personalised approach to medicine optimisation. Methods All 42 patients under the care of the local 'Hospital at Home' team had their medication reviewed by the team's Consultant Pharmacist for Older People. Using the STOP START tool with information from patients and carers each patient's medication was optimised. Results This data was analysed by a research pharmacist and anticholinergic burden, Eadon score, pill burden, adverse drug events and average direct drug cost savings were identified. All residents had their medication optimised. 5.25 clinical interventions per resident 81% were Eadon Grade 4. Medication appropriateness improved with downwards trend, pre and post intervention. The mean anticholinergic burden reduced to less than 3. (pre 3.63 vs post 2.63). An overall reduction in pill burden; for every 1 drug started 3 drugs were stopped (mean number of drugs 16 vs 13, pre and post intervention respectively). 50% of residents had an adverse drug event (causing harm) identified. Average direct drug costs savings of £385.28 per patient per annum. Conclusion This research shows the importance of the role of the 'Consultant Pharmacist for OIder People' in medicine optimisation in the 'Hospital at Home' team. It also highlights the benefit of the 'Hospital at Home' service to facilitate the often time-consuming task of effective medicine optimisation.
Databáze: OpenAIRE