Improving medication management across the continuum remains one of the greatest challenges in modern health care. The period 7 to 10 days following hospital discharge is a vulnerable time, with approximately 50% of adults discharged experiencing a medical error, most often an adverse drug event.
People in rural and remote Australia present later and sicker to hospitals than their counterparts in major cities. The City Country Medslink project will explore the benefits and barriers to a framework focussed on integrating care and reducing medication misadventure by providing a pharmacist-led medication review, conducted in the home (HMR) within 10 days of discharge from hospital.
Led by Goldfields Midwest Medicare Local, Sir Charles Gairdner Hospital and The University of Western Australia, a four-month study was carried out to explore the current medication management in a tertiary hospital from a regional and remote region. The findings from this study will enable us to find better ways to improve medication management on discharge.
The studied participants were elderly, had multiple comorbidities, significant polypharmacy and extended length of hospital stay. Provision of a HMR post discharge provides a logical medication safety initiative for such a high risk cohort.
Health care providers in the Midwest of Western Australia have traditionally embraced HMRs, with the greatest number of HMRs per capita in Australia reported in 2010. Most participants from this regional centre received a post discharge HMR in a timely fashion. In contrast, participants from remote communities were unable to gain access to the service.
The City Country Medslink project used a collaborative, patient-centred approach involving the patient’s usual primary care providers across the care continuum. It highlighted the high risk of medication misadventure in country patients and the benefits of established relationships in longitudinal patient care. The inability of patients from remote communities to access this important safety initiative requires urgent attention.
You can hear more details on the method and findings of this study at the 5th annual Discharge Planning Conference, taking place on the 24th and 25th July in Melbourne. To see the complete conference agenda and to register, please visit the Discharge Planning Conference website.
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