The impact of a hospital outreach medication review service on hospital readmission and emergency department attendances

Abstract

AbstractBackgroundThe Monash Health Hospital Outreach Medication Review (HOMR) service is a pharmacist‐led service that targets patients at high risk of medication misadventure in the immediate post‐discharge period.AimTo study the impact of a HOMR service on emergency department attendances and hospital admissions within an Australian hospital network.MethodInformation was collected on the total number of emergency department attendances and hospital admissions during the 12‐month period prior to, and after, the date a HOMR service was provided to the study group between 1 January 2012 and 22 November 2012. This was compared to a control group who were referred to the service and were eligible, but rejected the service. Patients were stratified by age (≤50, 51–65 and >65 years) to determine any age‐related variations and tõhen investigated excluding regular, planned admissions (dialysis, chemotherapy or transfusion‐related).ResultsThe 398 patients in the study group had a total of 1691 admissions in the 12‐month period pre‐HOMR. The total number of admissions in the 12‐month period post‐HOMR was higher than during the pre‐HOMR period for both the control and study groups. When an age subanalysis was conducted and regular planned admissions were excluded, patients aged 51–65 years exhibited a 25% reduction in hospital admissions (χ2 = 6.14, p < 0.05). There was no significant reduction in admissions for the other age groups or in emergency department attendances.ConclusionThe provision of HOMR outreach services has a valuable role to play in a clearly identified population that is at high risk of medication misadventure.