Abstract
BackgroundElderly patients are vulnerable to adverse drug reactions (ADRs). Drug-related readmissions (DRRs) can be a major consequence of ADR. Therefore, this study aimed to investigate the effects of a ward-based, comprehensive pharmaceutical care service on the occurrence of DRRs as the endpoint in dependent-living elderly patients.MethodsA randomized, controlled trial was performed at a German University Hospital. Patients fulfilling the following criteria were eligible: admission to a cooperating ward, existing drug therapy at admission, 65 years of age and older, home-care or nursing home residents in ambulatory care, and a minimum hospital stay of three days. Patients received either standard care (control group) or pharmaceutical care (intervention group). Follow-up consultations were conducted for each patient at 1, 8, 26, and 52 weeks after discharge. The time to DRR was defined as the primary outcome measure and was analysed using the log-rank test. The Cox-proportional hazard model was used for risk factor analysis.ResultsSixty patients (n = 31 intervention group, n = 29 control group) participated in the study. For patients in the intervention group, the median time to DRR was prolonged; however, the level of statistical significance was not reached (log-rank test P = 0.068; HR = 3.28, P = 0.086). When the risk factors ‘age’ or ‘length of stay on the ward’ were added to the Cox proportional hazard model, patients in the control group exhibited a significantly higher risk of experiencing a DRR than patients of the intervention group (HR = 4.62; P = 0.028 including age and HR = 5.76; P = 0.033 including length of stay on the ward).ConclusionsOur findings demonstrate the successful implementation of ward-based, comprehensive pharmaceutical care for dependent-living elderly. Despite a low participation rate, which led to an underpowered study, the results provide a preliminary efficacy signal and effect size estimates to power a definitive trial.Trial registrationClinicaltrials.gov identifier: NCT01578525, prospectively registered April 13, 2012.
Highlights
Patients are vulnerable to adverse drug reactions (ADRs)
The drug-related problem (DRP) were documented and classified using the APS-Doc system [22], which we extended with three more subcategories in ‘others’
Thirty patients were allocated to the control group and 31 patients to the intervention group
Summary
Patients are vulnerable to adverse drug reactions (ADRs). Drug-related readmissions (DRRs) can be a major consequence of ADR. This study aimed to investigate the effects of a ward-based, comprehensive pharmaceutical care service on the occurrence of DRRs as the endpoint in dependent-living elderly patients. Strategies to prevent adverse drug reactions (ADRs) and drug-related hospital admissions are urgently needed, for elderly patients [4,5,6]. Several studies have demonstrated the positive patientindividual and economic impacts of pharmaceutical care [12,13,14,15,16] Despite these results, few studies have evaluated the efficacy of pharmaceutical care services in hospitalized patients to reduce patient morbidity and mortality, in high-quality and long follow-up trials [6]. Pharmaceutical care services are still limited and underrepresented in many countries in hospital as well as ambulatory care The provision of those services, may prevent adverse drug reactions and subsequent hospital admissions. The effect of a ward-based pharmaceutical care service on drug-related readmissions is a relevant and interesting topic for research [13, 17, 18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
