Evaluation indicates lower rate of readmissions for patients using post-discharge scheme (October 2016)
Published on: 15th May 2017 | Updated on: 28th March 2022
BMJ Open has published a paper on the evaluation of an electronic system which refers patients who have been discharged from hospital to a local community pharmacy for a follow-up consultation with a pharmacist. The evaluation indicates that patients who receive the follow-up consultation may have lower rates of readmissions and shorter hospital stays if they are readmitted.
The initiative, a Transfer of Care Scheme, is a collaborative project between Newcastle-upon-Tyne NHS Foundation Trust, North of Tyne LPC and Pinnacle Health Partnership LLP (provider of PharmOutcomes, which is used to facilitate information transfer between the hospital and community pharmacy, and who provided data for the evaluation).
The scheme, which is ongoing in the North East of England and North Cumbria, involved two hospital sites and 207 community pharmacies. The evaluation period covered July 2014 to July 2015.
To evaluate the service, the patient population was categorised into two groups: those who received a follow-up consultation with a community pharmacist, and those that did not. The authors of the evaluation particularly looked at the rates of readmission to hospital at 30, 60 and 90 days post referral and number of hospital bed days.
The researchers found that the odds of readmission were significantly higher among those who did not receive a follow-up consultation from the community pharmacist. Among readmitted patients who did received a post-discharge consultation with a community pharmacist, the duration of hospital stay was shorter by at least five days than those who did not receive a consultation.
This service demonstrates the benefits of collaborative working and the support that community pharmacy teams can provide to patients recently discharged from hospital.
How does the service work?
Hospital staff make a clinical judgement to identify suitable patients who would benefit from a follow-up consultation with a community pharmacist post-discharge. These include patients on four or more medicines or those who have had a number of medicines changed during their hospital stay. The patient then nominates a pharmacy of their choice, and an electronic referral is made to the pharmacy via PharmOutcomes. Community pharmacists can then either accept the referral and arrange a follow up consultation or reject the referral and provide a reason for doing so.
During the consultation between the community pharmacist and patient, examples of issues explored include whether the patient understands how to take their medicines, if they have experienced an adverse drug reaction, or if the patient may benefit from any other service such as the Medicines Use Review service or a stop smoking service.
Further information on this service and other discharge support and reablement support services can be found on the Community Pharmacy England Services Database.