Minding the gap-an examination of a pharmacist case management medicines optimisation intervention for older people in intermediate care settings

Ann Sinéad Doherty, Gary Adamson, John Mallett, Carmel Darcy, Anne Friel, Michael G. Scott, EF Ruth Miller

Research output: Contribution to journalArticlepeer-review

Abstract

Background Whilst attention has been paid within the literature to examining potentially inappropriate prescribing (PIP) for older adults in a variety of care settings, less is known about the extent within intermediate care. Furthermore, few studies have examined the utility of clinical pharmacist involvement in this care context. Objective(s) Determine the prevalence of PIP in intermediate care (IC) settings in Northern Ireland (NI), explore the utility of a novel pharmacist case management model at reducing PIP and to examine the association with subsequent healthcare utilisation. Methods Secondary analysis of prospective data (N = 532) collected during a medicines optimisation pharmacist case management model in three intermediate care sites in NI. Independent prescriber pharmacists delivered the intervention. Variability in Medication Appropriateness Index score change (ΔMAI) from admission to discharge was examined using multivariate linear regression analysis. Multivariate logistic and Poisson regressions were used to examine the association between ΔMAI and likelihood and numbers of unplanned hospital readmissions within 30 and 90 days of IC discharge. Results PIP was highly prevalent (89.5%) at baseline with significant reductions in MAI score achieved from admission (Median = 14) to discharge (Median = 0) (Z = −18.28, p 
Original languageEnglish
JournalResearch in Social and Administrative Pharmacy
Early online date11 Apr 2022
DOIs
Publication statusE-pub ahead of print - 11 Apr 2022

Keywords

  • Medicines optimisation
  • Potentially inappropriate prescribing
  • Pharmacist intervention
  • Case management
  • Healthcare utilisation

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