Pharmacist reviews fail to prevent hospital admissions
Medication reviews by pharmacists appear to increase emergency hospital
admissions, according to a study published this week (BMJ
Online First).
Researchers randomised 872 elderly patients discharged from hospital
after an emergency admission to receive two home visits by a pharmacist
(intervention group) or usual care (control group).
The intervention increased further admissions by 30 per cent and home
visits by GPs by 43 per cent. It also seemed to worsen patients’ quality
of life compared with controls but tended to decrease the risk of death.
The researchers suggest three explanations. First, pharmacists may have
helped
patients understand their condition better, leading to patients recognising
warning signs earlier and promoting better help-seeking behaviour. This
explanation is supported by the non-significant decrease in deaths observed.
A second interpretation is that pharmacists are likely to have encouraged
patients to
adhere to their medication regimens, which might have precipitated side
effects or drug interactions. Another possibility is that the
intervention simply added to the complexity of patient care, increasing
anxiety and dependence on health services.
“Either way, a growing body of evidence suggests that further research
is necessary to elucidate the most effective form and detailed effects
of medication review. The recommendation in the National Service Framework
for Older People that this should be widely introduced in primary care
seems to lack a clear evidence base,” the researchers conclude. |
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Pharmaceutical Journal
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