Ensuring continuity of patient care across the healthcare interface Telephone follow-up post-hospitalization

    Research output: Contribution to journalArticle

    Published
    • Mohanad Odeh
    • Claire Scullin
    • Glenda Fleming
    • Michael G Scott
    • Robert Horne
    • James C McElnay

    View graph of relations

    AIMS: To implement pharmacist-led, postdischarge telephone follow-up (TFU) intervention and to evaluate its impact on rehospitalization parameters in polypharmacy patients, via comparison with a well-matched control group.

    METHOD: Pragmatic, prospective, quasi-experimental study. Intervention patients were matched by propensity score techniques with a control group. Guided by results from a pilot study, clinical pharmacists implemented TFU intervention, added to routine integrated medicines management service.

    RESULTS: Using an intention to treat approach, reductions in 30- and 90-day readmission rates for intervention patients compared with controls were 9.9% [odds ratio = 0.57; 95% confidence interval (CI): 0.36-0.90; P < 0.001] and 15.2% (odds ratio = 0.53; 95% CI: 0.36-0.79; P = 0.021) respectively. Marginal mean time to readmission was 70.9 days (95% CI: 66.9-74.9) for intervention group compared with 60.1 days (95% CI: 55.4-64.7) for controls. Mean length of hospital stay compared with control was (8.3 days vs. 6.7 days; P < 0.001). Benefit: cost ratio for 30-day readmissions was 29.62, and 23.58 for 90-day interval. Per protocol analyses gave more marked improvements. In intervention patients, mean concern scale score, using Beliefs about Medicine Questionnaire, was reduced 3.2 (95% CI: -4.22 to -2.27; P < 0.001). Mean difference in Medication Adherence Report Scale was 1.4 (22.7 vs. 24.1; P < 0.001). Most patients (83.8%) reported having better control of their medicines after the intervention.

    CONCLUSIONS: Pharmacist-led postdischarge structured TFU intervention can reduce 30- and 90-day readmission rates. Positive impacts were noted on time to readmission, length of hospital stay upon readmission, healthcare costs, patient beliefs about medicines, patient self-reported adherence and satisfaction.

    Documents

    • Ensuring continuity of patient care across the healthcare interface Telephone follow-up post-hospitalization

      Rights statement: Copyright 2019 Wiley. This work is made available online in accordance with the publisher’s policies. Please refer to any applicable terms of use of the publisher.

      Accepted author manuscript, 138 KB, PDF-document

      Embargo ends: 24/01/2020

    DOI

    Original languageEnglish
    Pages (from-to)616-625
    JournalBritish Journal of Clinical Pharmacology
    Journal publication date18 Feb 2019
    Issue number3
    Volume85
    Early online date24 Jan 2019
    DOIs
    Publication statusPublished - 18 Feb 2019

    ID: 165566895