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评估综合性药物管理服务在出院后对再入院和急诊就诊的影响。

Evaluation of the impact of comprehensive medication management services delivered posthospitalization on readmissions and emergency department visits.

机构信息

University of Minnesota College of Pharmacy, 7-174 Weaver-Densford Hall, 308 Harvard St. S.E., Minneapolis, MN 55455.

出版信息

J Manag Care Spec Pharm. 2014 Sep;20(9):886-93. doi: 10.18553/jmcp.2014.20.9.886.

Abstract

BACKGROUND

The impact of providing cognitive pharmacy services following hospital discharge has been studied with various results. This study is specifically focused on comprehensive medication management services delivered postdischarge in an interprofessional team environment to patients aged >65 years.

OBJECTIVE

To determine if delivery of comprehensive medication management services postdischarge will prevent hospital readmissions or emergency department visits within 6 months following discharge in patients aged >65 years. Secondary endpoints included 30-day and 60-day postdischarge events.

METHODS

This was a prospective group matched-controlled study of patients aged >65 years with selected diagnoses identified as high risk for readmission. The intervention group received comprehensive medication management that was provided face-to-face in the patient's primary care clinic within 2 weeks of discharge.

RESULTS

No statistically significant difference was found between intervention and control groups in hospital readmissions or emergency department visits at 30 days, 60 days, or 6 months after discharge. No statistically significant difference was seen in mortality between groups.

CONCLUSIONS

Provision of comprehensive medication management services did not reduce emergency department visits or readmissions in this study. This study was limited by multiple other changes occurring in the health system during the time of this study that potentially confounded results. In addition, the study may have been too small to detect a difference.

摘要

背景

提供出院后认知药学服务的影响已通过各种研究结果进行了研究。本研究专门针对在跨专业团队环境中为> 65 岁的患者提供的综合药物管理服务。

目的

确定在> 65 岁的患者出院后提供综合药物管理服务是否会防止在出院后 6 个月内再次住院或急诊就诊。次要终点包括 30 天和 60 天的出院后事件。

方法

这是一项前瞻性分组对照研究,纳入了选定的诊断为高风险再入院的> 65 岁患者。干预组在出院后 2 周内接受面对面的综合药物管理,在患者的初级保健诊所进行。

结果

在出院后 30 天、60 天或 6 个月时,干预组与对照组在住院再入院或急诊就诊方面没有统计学上的显著差异。两组之间在死亡率方面也没有统计学上的显著差异。

结论

在本研究中,提供综合药物管理服务并未降低急诊就诊或再入院率。本研究受到多种其他因素的限制,这些因素可能会影响研究结果。此外,该研究的规模可能太小,无法检测到差异。

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