Evaluation of effect of pharmacy discharge planning on medication problems experienced by discharged acute admission mental health patients

Abstract

Objective. To evaluate the effect of pharmacy discharge planning on the pharmaceutical care issues experienced by discharged mental health patients. Method. 97 patients recruited from three acute-admission psychiatric wards were randomly allocated to either an intervention group (receiving a baseline pharmaceutical needs assessment, information about medicines and then a pharmacy discharge plan sent to their community pharmacy) or a control group (no such additional pharmaceutical care). Domiciliary visits were carried out at one, four and 12 weeks post-discharge and medicine knowledge and the number and types of medication problems experienced were assessed at each visit. Community pharmacists were questioned about problems with individual prescriptions and use of the discharge plan, where relevant, after each domiciliary visit. Key findings. There was no significant difference between the groups in baseline medicine knowledge. One week post-discharge, both groups showed significant (P < 0.002) improvement in knowledge of medication from baseline and this improvement was maintained at 12 weeks. No significant difference was found between knowledge scores for the two groups on any occasion. Fewer medication problems were recorded for the intervention group. There was a trend for reduced readmissions for the intervention group, but this was not statistically significant (P = 0.065) Community pharmacists in receipt of plans were more likely to identify problems than other pharmacists. Conclusions. Further work is needed to evaluate whether the effectiveness of pharmacy discharge planning may be improved by providing information to general practitioners and community psychiatric nurses in addition to community pharmacists, as in this study.