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 Telephone outreach from pharmacists has long been linked to higher
odds that patients will take all of their medicines as prescribed,
researchers note in The British Journal of Clinical Pharmacy. But
research to date hasn't provided a clear picture of whether there
could be additional benefits like reducing complications that send
recently discharged patients back to the hospital.
For the current study, researchers compared outcomes for 221 adult
patients scheduled to receive calls from pharmacists within one week
of discharge, and again at one and three months, with a control
group of 221 similar patients who were not assigned to get
pharmacist calls. All the participants were taking 10 or more
prescribed medications, and nearly two-thirds were age 65 or older.
Compared to patients who didn't get calls, those who got all three
follow-up calls were 78 percent less likely to have a repeat
hospitalization within 30 days and 66 percent less likely to be
readmitted within 90 days, the study found.
"Patients who received the telephone calls became less concerned
about their medicine and there was evidence that they improved their
medication taking behavior (adherence)," said senior study author
James Charles McElnay, a pharmacy researcher at Queen's University
Belfast in the UK.
"The decreased rehospitalization rate led to significant financial
savings, and patients were very satisfied with the new service,"
McElnay said by email.
By the end of the study, patients who received all or some of the
calls from pharmacists were more convinced of the necessity of
taking all their medicines as prescribed than people who didn't get
the calls. With the phone outreach, patients also had fewer concerns
about safety and side effects.
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One limitation of the study is that it was conducted at a single
medical center, using hospital pharmacists, and results might not
reflect what would happen with follow-up calls from pharmacists in
other settings like retail drugstores.
Researchers also lacked data on the cause for repeat
hospitalizations, and lacked data on a variety of other factors that
might influence a patient's odds of repeat hospitalization.
Evidence to date on interventions to follow-up with patients after
discharge to prevent readmissions has been of mixed quality and
produced highly variable results, noted Dr. Michael Barnett, a
researcher at the Harvard T. H. Chan School of Public Health in
Boston who wasn't involved in the study.
"I think in general we have learned that doing something is better
than doing nothing, and comprehensive interventions seem to work
better, but not always," Barnett said by email.
What the current study and others that have investigated efforts to
curb readmissions do clearly show is that patients need to be clear
on their plans for follow-up care before they leave the hospital,
Barnett said.
"They should always see their primary care physician within 7 to 14
days of leaving the hospital unless they are told it's not
necessary," Barnett advised. "I can't tell you the number of
problems I need to readjust after a patient leaves the hospital."
SOURCE: https://bit.ly/2GRNDmR British Journal of Clinical Pharmacy,
online January 23, 2019.
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