A pharmacy discharge plan for hospitalized elderly patients - a randomizedcontrolled trial

Objectives: to investigate the effectiveness of a pharmacy discharge plan i n elderly hospitalized patients. Design: randomized controlled trial. Subjects and settings: we randomized patients aged 75 years and older on fo ur or more medicines who had been discharged from three acute general and o ne long-stay hospital to a pharmacy intervention or usual care. Interventions: the hospital pharmacist developed discharge plans which gave details of medication and support required by the patient. A copy was give n to the patient and to all relevant professionals and carers. This mas fol lowed by a domiciliary assessment by a community pharmacist. In the control group, patients were discharged from hospital following standard procedure s that included a discharge letter to the general practitioner listing curr ent medications. Outcomes: the primary outcome was re-admission to hospital within 6 months. Secondary outcomes included the number of deaths, attendance at hospital o utpatient clinics and general practice and proportion of days in hospital o ver the follow-up period, together with patients' general well-being, satis faction with the service and knowledge of and adherence to prescribed medic ation. Results: we recruited 362 patients, of whom 181 were randomized to each gro up. We collected hospital and general practice data on at least 91 and 72% of patients respectively at each follow-up point and interviewed between 43 and 90% of the study subjects. There were no significant differences betwe en the groups in the proportion of patients re-admitted to hospital between baseline and 3 months or 3 and 6 months. There were no significant differe nces in any of the secondary outcomes. Conclusions: we found no evidence to suggest that the co-ordinated hospital and community pharmacy care discharge plans in elderly patients in this st udy influence outcomes.