2021
DOI: 10.5694/mja2.50942 View full text |Buy / Rent full text
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Abstract: Objective To investigate whether integrating pharmacists into general practices reduces the number of unplanned re‐admissions of patients recently discharged from hospital. Design, setting Stepped wedge, cluster randomised trial in 14 general practices in southeast Queensland. Participants Adults discharged from one of seven study hospitals during the seven days preceding recruitment (22 May 2017 ‒ 14 March 2018) and prescribed five or more long term medicines, or having a primary discharge diagnosis of conges… Show more

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“…Program changes could also incorporate new models of care for medicines reviews. For example, post-discharge medicines reviews by integrated general practice pharmacists can reduce hospital readmissions and emergency department presentations [ 27 ]. Provision of HMRs at the time of an aged care eligibility assessment can resolve medicines-related problems [ 28 ], while integration of pharmacists within RACFs improves medication administration practices [ 29 ].…”
Section: Discussionmentioning
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“…Program changes could also incorporate new models of care for medicines reviews. For example, post-discharge medicines reviews by integrated general practice pharmacists can reduce hospital readmissions and emergency department presentations [ 27 ]. Provision of HMRs at the time of an aged care eligibility assessment can resolve medicines-related problems [ 28 ], while integration of pharmacists within RACFs improves medication administration practices [ 29 ].…”
Section: Discussionmentioning
“…While a limited number of studies indicated that general practice pharmacists’ activities improved patients’ health outcomes, evidence based on the use of robust methodologies is still lacking. Only one recent study, published outside of the search period of this review, utilised a randomised controlled trial [ 87 ]. This article reported that general practice pharmacists’ medication management services reduced the number of unplanned hospital admissions for patients recently discharged from hospitals who were prescribed five or more long-term medicines or had a primary discharge diagnosis of congestive heart failure or exacerbation of chronic obstructive pulmonary disease [ 87 ].…”
Section: Discussionmentioning
“…Only one recent study, published outside of the search period of this review, utilised a randomised controlled trial [ 87 ]. This article reported that general practice pharmacists’ medication management services reduced the number of unplanned hospital admissions for patients recently discharged from hospitals who were prescribed five or more long-term medicines or had a primary discharge diagnosis of congestive heart failure or exacerbation of chronic obstructive pulmonary disease [ 87 ]. The estimated incremental net cost-benefit of the general practice pharmacist-led medication management services was AUD 5072 per patient, with a benefit-cost ratio of 31:1 [ 87 ].…”
Section: Discussionmentioning
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“…Furthermore, this service could be replicated in the community by a collaborative effort between the General Practice Pharmacist and the GP ( 9 ). The community PGS team could address the complex needs of at-risk polypharmacy patients following their discharge from hospital back into primary care ( 30 ). Indeed, the biggest impact of the PGS could be in residential aged care facilities, which have recently been highlighted as a major location for polypharmacy, inappropriate prescribing, and lack of dose optimisation resulting in significant patient harm ( 31 , 32 ).…”
Section: Discussionmentioning