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Pharmacist particip...
Pharmacist participation in hospital ward teams and hospital readmission rates among people with dementia : a randomized controlled trial
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- Gustafsson, Maria (author)
- Umeå universitet,Geriatrik,Farmakologi
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- Sjölander, Maria (author)
- Umeå universitet,Farmakologi
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- Pfister, Bettina (author)
- Umeå universitet,Farmakologi
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- Jonsson, Jeanette (author)
- Umeå universitet,Farmakologi
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- Schneede, Jörn (author)
- Umeå universitet,Farmakologi
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- Lövheim, Hugo (author)
- Umeå universitet,Geriatrik
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(creator_code:org_t)
- 2017-04-08
- 2017
- English.
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In: European Journal of Clinical Pharmacology. - : Springer. - 0031-6970 .- 1432-1041. ; 7:73, s. 827-835
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Abstract
Subject headings
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- Purpose: To assess whether comprehensive medication reviews conducted by clinical pharmacists as part of a healthcare team reduce drug-related hospital readmission rates among people with dementia or cognitive impairment.Methods: This randomized controlled trial was carried out between January 9, 2012, and December 2, 2014. Patients aged ≥65 years with dementia or cognitive impairment admitted to three wards at two hospitals located in Northern Sweden were included.Results: Of the 473 deemed eligible for participation, 230 were randomized to intervention and 230 to control group by block randomization. The primary outcome, risk of drug-related hospital readmissions, was assessed at 180 days of follow-up by intention-to-treat analysis.During the 180 days of follow-up, 18.9% (40/212) of patients in the intervention group and 23.0% (50/217) of those in the control group were readmitted for drug-related reasons (HR = 0.80, 95% CI = 0.53–1.21, p = 0.28, univariable Cox regression). Heart failure was significantly more common in the intervention group. After adjustment for heart failure as a potential confounder and an interaction term, multiple Cox regression analysis indicated that pharmacist participation significantly reduced the risk of drug-related readmissions (HR = 0.49, 95% CI = 0.27–0.90, p = 0.02). A post-hoc analysis showed a significantly reduced risk of 30-day readmissions due to drug-related problems in the total sample (without adjustment for heart failure).Conclusion: Participation of clinical pharmacists in healthcare team conducting comprehensive medication reviews did not significantly reduce the risk of drug-related readmissions in patients with dementia or cognitive impairment; however, post-hoc and subgroup analyses indicated significant effects favoring the intervention. More research is needed.Trial registration: Clinical trials NCT01504672.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Geriatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Geriatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Samhällsfarmaci och klinisk farmaci (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Social and Clinical Pharmacy (hsv//eng)
Keyword
- Medication reviews
- Clinical pharmacists
- Drug-related readmissions
- Dementia
- Old people
Publication and Content Type
- ref (subject category)
- art (subject category)
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