Transition of care: A set of pharmaceutical interventions improves hospital discharge prescriptions from an internal medicine ward

Article Article scientifique Article Transition of care: A set of pharmaceutical interventions improves hospital discharge prescriptions from an internal medicine ward eng 2017 author Neeman Marine 677488 author Dobrinas Maria 640060 author Maurer Sophie 677123 author Tagan Damien author Sautebin Annelore author Blanc Anne-Laure 604230 author Widmer Nicolas 0000-0001-7392-2418 604325 30-37 10.1016/j.ejim.2016.11.004 27890453 0953-6205 Background: Continuity of care between hospitals and community pharmacies needs to be improved to ensure medication safety. This study aimed to evaluate whether a set of pharmaceutical interventions to prepare hospital discharge facilitates the transition of care. Methods: This study took place in the internal medicine ward and in surrounding community pharmacies. The intervention group's patients underwent a set of pharmaceutical interventions during their hospital stay: medication reconciliation at admission, medication review, and discharge planning. The two groups were compared with regards to: number of community pharmacist interventions, time spent on discharge prescriptions, and number of treatment changes. Results: Comparison between the groups showed a much lower (77% lower) number of community pharmacist interventions per discharge prescription in the intervention (n = 54 patients) compared to the control group (n = 64 patients): 6.9 versus 1.6 interventions, respectively (p < 0.0001); less time working on discharge prescriptions; less interventions requiring a telephone call to a hospital physician. The number of medication changes at different steps was also significantly lower in the intervention group: 40% fewer (p < 0.0001) changes between hospital admission and discharge, 66% fewer (p < 0.0001) between hospital discharge and community pharmacy care, and 25% fewer ( p= 0.002) between community pharmacy care and care by a general practitioner. Conclusion: An intervention group underwent significantly fewermedication changes in subsequent steps in the transition of care after a set of interventions performed during their hospital stay. Community pharmacists had to perform fewer interventions on discharge prescriptions. Altogether, this improves continuity of care. (C)2016 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved. Adult Aged Aged, 80 and over Case-Control Studies Female Humans Internal Medicine Male Medication Reconciliation Middle Aged Patient Admission Patient Discharge Patient Transfer/standards Pharmacies/standards Pharmacists Pharmacy Service, Hospital/standards Professional Role Switzerland Dewey 615 31 Section des sciences pharmaceutiques 17 false 887 Pharmacie hospitalière et clinique European Journal of Internal Medicine 38 1775d4b9-dca1-4bb5-a8cb-c7e5c0024e92 Article (Published version) Restricted Transition_of_care_hospital.pdf 772355 application/pdf restrictedAccess Faculté des sciences / Section des sciences pharmaceutiques

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Transition of care: A set of pharmaceutical interventions improves hospital discharge prescriptions from an internal medicine ward	European Journal of Internal Medicine	2017	277	1
Etude pharmacogénétique sur la mémantine		2011	328	7

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Maurer, Sophie