Evaluating the Connect with Pharmacy web-based intervention to reduce hospital readmission for older people

Abstract

Background The patient transition from a hospital to a post-discharge healthcare setting has potential to disrupt continuity of medication management and increase the risk of harm. “Connect with Pharmacy” is a new electronic web-based transfer of care initiative employed by Leeds Teaching Hospitals NHS Trust. This allows the sharing of discharge information between the hospital and a patient’s chosen community pharmacy. Objective We investigated whether the timely sharing of discharge information with community pharmacies via “Connect with Pharmacy” reduced hospital readmission rates in older patients. Method To evaluate intervention efficacy, hospital admission data was retrospectively collected. For primary analysis, admission rates were tracked 6-months prior (baseline) and 6-months post-intervention. Secondary measures included effect on total length of stay if readmitted, emergency department attendance and duration, and impact of polypharmacy. Main outcome measure The rate of non-elective hospital readmissions, 6-months post-intervention. Results In the sample (n = 627 patients; Mean age = 81 years), emergency readmission rates following the intervention (M = 1.1, 95% CI [0.98, 1.22]) reduced by 16.16% relative to baseline (M = 1.31, 95% CI [1.21, 1.42]) (W = 54,725; p < 0.001). There was no reduction in total length of stay. Subsidiary analysis revealed a post-intervention reduction in number of days spent in hospital lasting more than three days (χ2 = 13.37, df = 1, p < 0 .001). There were no statistically reliable differences in the remaining secondary measures. Conclusion The results showed a reduction in readmissions and potential post-intervention length of stay, indicating there may be further benefits for our older patients’ experiences and hospital flow.

Post‐discharge medicines management: the experiences, perceptions and roles of older people and their family carers

“…Some progress has been made however, with a new UK discharge service announced by the Department of Health and Social Care 48 . This appears to focus on the transfer of information from the hospital to community pharmacy, similar to services already available in some places 49,50 . Whilst it is unknown what is available within this service, it currently does not appear to integrate the patient within it.…”

“…48 This appears to focus on the transfer of information from the hospital to community pharmacy, similar to services already available in some places. 49,50 Whilst it is unknown what is available within this service, it currently does not appear to integrate the patient within it. Given the lack of engagement and involvement highlighted by this study, it would be beneficial to rethink future services and ensure they are truly person-centred.…”

Pharmacy professionals’ views regarding the future of NHS patient medicines helpline services: a multimethod qualitative study

“…Therefore, the groups were not even matched. This study design is typical of the available evidence pertaining to the TCAM scheme [54][55][56], and so, higher quality research is needed to establish its effectiveness for reducing readmissions (i.e., a randomised controlled trial). Based upon the limited available evidence to date, it has been estimated that TCAM saved the health economy more than 50 million pounds in 2018-2019, by reducing the number of hospital readmissions [52].…”

Using Technology-Supported Transfer of Care Systems: Informing Good Practice Recommendations

“…Each of these systems use technology to provide community pharmacists access to discharge information for their patients, allowing them to provide post-discharge medicines support to patients via a range of a commissioned services, which differ between countries. The evidence base supporting the use of some of these systems and the services they underpin is growing, with proven patient safety benefits, including identifying medication discrepancies and an association with a reduction in the risk of hospital readmission [ 13 , 15 , 16 , 17 ]. Despite the benefits of these systems, there is a paucity of published literature on their strategic implementation, processes and use.…”