Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors
| Autor: | Heather Kreutz, Alfred E. Lyman, Jody Adams, Thomas Delate, Mary Beth Dowd, Wendolyn S. Gozansky, Paul B. Shaw, Julia K. Sanchez |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
business.industry MEDLINE 030208 emergency & critical care medicine Retrospective cohort study Emergency department Clinical pharmacy 03 medical and health sciences 0302 clinical medicine Family medicine Health care Workforce Emergency medicine Medication therapy management Emergency Medicine medicine Observational study 030212 general & internal medicine business |
| Zdroj: | Annals of Emergency Medicine. 67:177-188 |
| ISSN: | 0196-0644 |
| DOI: | 10.1016/j.annemergmed.2015.06.022 |
| Popis: | Study objective This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. Methods This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. Results A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Conclusion Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. |
| Databáze: | OpenAIRE |
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