Discharge Prescription Review

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Discharge Prescription Review

• Niamh Mc Garry
• Senior Pharmacist
• Mater Misericordiae Hospital
• April 2002

2
Contents

• Introduction
• Objectives
• Method
• Outcomes
• Budget
• Summary
• Conclusion

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Introduction Discharge Process

• Seamless care has been defined as the smooth
  transfer of care for patients between primary
  and secondary care.
• Oborne, Pharmaceutical Journal 1994.
• Pharmacists have vital role to play in the
  discharge process.
• Currently in Republic of Ireland, pharmacists
  have a limited role in the discharge process.

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Introduction Discharge Prescriptions

• Medicine-related problems on discharge can lead
  to increased morbidity, avoidable adverse
  effects, and more frequent re-admissions to
  hospital.
• Some of these problems can be avoided by
  monitoring discharge prescriptions.
• Reviewing of discharge prescriptions is the first
  step in pharmacist involvement in the discharge
  process in the Mater Misericordiae Hospital.

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Objectives

• To assess the feasibility of the introduction of
  a discharge prescription review service.
• To show that interventions made will improve
  patient care.

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Method (1)

• Cardiology wards selected.
• Permission obtained and ward staff notified.
• 100 Prescriptions will be reviewed.
• Time taken to review prescriptions, patient
  details and details of any intervention made will
  be recorded.

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Method (2)

• The impact of each intervention on patient care
  will be assessed by a multi-disciplinary panel.

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Results so far

• 50 prescriptions reviewed.
• 1 in 3 prescriptions have involved interventions.
• Number of potentially significant interventions.

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Outcomes

• Show that review of discharge prescriptions can
  benefit patient care and contribute to seamless
  care.
• Highlight common problems on discharge
  prescriptions.
• Propose that discharge process should be planned
  to accommodate the inclusion of a pharmacist.

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Budget

• Select 3 hospitals in the United Kingdom which
  currently have a ward-based pharmacist reviewing
  discharge prescriptions.
• Servier Award could be used to fund visits to
  each of these centres.
• The practice in these hospitals could be observed
  and adapted for the implementation of a discharge
  prescription review service in the Mater
  Misericordiae Hospital.

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Summary

• Rationale for review of discharge prescriptions.
• Outline of method.
• Potential benefit of pharmacist reviewing
  discharge prescription.
• Implementation of this service on an ongoing
  basis.

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Conclusion

• Early indications are that pharmacists may have a
  valuable role in reviewing discharge
  prescriptions in the MMH.
• The Servier award would help facilitate the
  implementation of this valuable service and both
  impact patient care and contribute towards
  seamless care.