학술논문

Integrated medicines management - can routine implementation improve quality?
Document Type
Article
Source
Journal of Evaluation in Clinical Practice. Aug2012, Vol. 18 Issue 4, p807-815. 9p. 10 Charts, 1 Graph.
Subject
*INTEGRATED health care delivery
*ACADEMIC medical centers
*AGE distribution
*ANALYSIS of covariance
*CHI-squared test
*CONFIDENCE intervals
*STATISTICAL correlation
*COST control
*COST effectiveness
*EPIDEMIOLOGY
*LENGTH of stay in hospitals
*HOSPITALS
*HOSPITAL health promotion programs
*PHARMACY databases
*INTERPROFESSIONAL relations
*LONGITUDINAL method
*MEDICAL care
*MEDICAL quality control
*MEDICAL cooperation
*MEDICAL prescriptions
*HEALTH outcome assessment
*PATIENTS
*QUALITY assurance
*RESEARCH
*RESEARCH funding
*STATISTICS
*SURVIVAL analysis (Biometry)
*LOGISTIC regression analysis
*DATA analysis
*PATIENT readmissions
*EVALUATION of human services programs
*DATA analysis software
*DESCRIPTIVE statistics
Language
ISSN
1356-1294
Abstract
Rationale, aims and objectives Previous service development work in the area of integrated medicines management (IMM) has demonstrated clear quality improvements in a targeted group of patients within a hospital in Northern Ireland. In order to determine whether this programme could be transferable to routine practice and thereby assess its generalizability, research has been carried out to quantify the health care benefits of incorporating the concept of IMM as routine clinical practice. Method The IMM programme of care was delivered to all eligible patients (subject to inclusion criteria) across two hospital sites in Northern Ireland during normal pharmacy opening hours. All patients were followed up for a period of 12 months from their time of hospital admission. All patient data were collected using the custom-designed Electronic Pharmacist Intervention Clinical System at each stage of their hospital journey, that is, admission, inpatient stay and discharge. Results Patients who received the IMM service benefited from a reduced length of hospital stay on their reference admission (1.42 days; P = 0.020) as well as a reduced length of stay during the first rehospitalization (5.86 days; P = 0.013). There was also a trend of a reduced number of readmissions and a longer time to readmission during the 12-month follow-up period. Potential significant opportunity cost savings were demonstrated as well as a significant improvement in medication appropriateness (discharge vs. reference admission). Conclusions The IMM programme of care has proven to be transferable to routine hospital care within two hospitals in Northern Ireland. It is anticipated that this current research will further inform the development of IMM as routine clinical practice across Northern Ireland and beyond. [ABSTRACT FROM AUTHOR]