Evaluating the Utilisation of a Service Designed to Enhance Care with Medicines Following Acute Hospital Discharge: A Retrospective Study

Abstract Introduction Medication safety challenges are common after hospital discharge and an important global health care improvement target [1,2]. ‘Transfers of Care Around Medicines’ (TCAM) services have been suggested as intervention that may help address this problem, designed to enable the referral patients on from a named community pharmacy in surrounding Clinical Commissioning Group (CCG). A TCAM service was launched by large NHS Trust England February 2019 enhance medicines communication optimisation between primary secondary following discharge. The is delivered through PharmOutcomes™ platform, initial focus support with new or existing Monitored Dosage Systems (MDS). Aim To evaluate utilisation host CCG examination nature outcome referrals made pharmacy. Method Anonymised delivery data referred via platform March – 2020 were retrospectively examined. comprised variables, including patient demographics, status time referrals, outcomes problems/errors identified medications provided such reconciliation. Study approvals obtained Health Research Authority (HRA); study exempt University Ethics Committee (UREC) approval [2019-7048-10983]. Results total 3,033 67 pharmacies analysed. Most for aged 70 above (72%, n=2,195) 56% (n=1,713/3,033) female patients. number varied 215 310 per month (median 246, Inter quartile range [IQR] 234 - 268). (67%, 2,038/3,033) marked ‘completed’ pharmacies, 32.8% (n=995) left uncompleted. rate completion 59 80% 66.4, IQR 64.5 70). Five (0.2%) had adverse drug reactions (ADRs) cohort 2,038 completed 45 (2%, n=45/2,038) having issues necessitated general practitioner (GP). most reason GP medication changes hospital, incorrect repeat prescriptions discharge, request prescription weekly MDS, inform has stopped taking their medication. carried out reported reconciliation (47%, n=954/2,038), followed review information (46.7%, n=952/2,038), home (39%, n=798/2,038), MDS arrangements (23.6%, n=482/2,038), commence (18.6%, n=380/2,038), managed (12%, n=254/2,038). main strength inclusion occurred over one-year period, while limited generalisability due one geographical region only using MDS. Conclusion findings ongoing development electronic systems use at References 1. Alqenae FA, Steinke D, Keers RN. Prevalence Nature Errors Medication-Related Harm Following Discharge Hospital Community Settings: Systematic Review. Drug safety. Mar 3:1–21. 2. World Organization. Global challenge: without harm. 2017; p. 1–16. http://apps.who.int/iris/bitstream/10665/255263/1/WHO-HIS-SDS-2017.6-eng.pdf?ua=1&ua=1 . Accessed 20 September 2020.