Abstract

To investigate the benefits of a community services liaison pharmacist in addressing medication misuse in elderly patients, which occur on both admission and discharge. Completion of a medication history for each patient on admission by the community liaison pharmacist. On discharge updated medication record sheets were faxed to the patient's GP and community pharmacy; a survey of GPs' and community pharmacists' opinions who were involved in the study was carried out. 109 patients over the age of 60 on 4 or more medications admitted by the medical admissions unit of Antrim Area Hospital. Medication related problems; GP and community pharmacist opinions of the service. Of the 109 patients, 61% had an incomplete medication history on admission, 21% of patients who brought their own drugs were not dealt with appropriately in hospital and 33% of discharged patients had medication-related problems. The service was felt to be very useful by GPs (80%) and community pharmacists (100%). A reduction in readmission rate of 2.4% was seen in these patients compared to the average for this age group. The community services liaison pharmacist produced benefits in terms of patient medication management, reduced readmission rates and wastage of patients' own drugs. A more detailed one-year study will now be carried out.

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