This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (1)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Randomized Controlled Trial  • Drug Therapy, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

A Randomized Controlled Trial

Ulrika Gillespie, MSc Pharm; Anna Alassaad, MSc Pharm; Dan Henrohn, MD, MSc, Pharm; Hans Garmo, PhD; Margareta Hammarlund-Udenaes, PhD; Henrik Toss, MD, PhD; Åsa Kettis-Lindblad, PhD; Håkan Melhus, MD, PhD; Claes Mörlin, MD, PhD

Arch Intern Med. 2009;169(9):894-900.

Background  Patients 80 years or older are underrepresented in scientific studies. The objective of this study was to investigate the effectiveness of interventions performed by ward-based pharmacists in reducing morbidity and use of hospital care among older patients.

Methods  A randomized controlled study of patients 80 years or older was conducted at the University Hospital of Uppsala, Uppsala, Sweden. Four hundred patients were recruited consecutively between October 1, 2005, and June 30, 2006, and were randomized to control (n = 201) and intervention (n = 199) groups. The interventions were performed by ward-based pharmacists. The control group received standard care without direct involvement of pharmacists at the ward level. The primary outcome measure was the frequency of hospital visits (emergency department and readmissions [total and drug-related]) during the 12-month follow-up period.

Results  Three hundred sixty-eight patients (182 in the intervention group and 186 in the control group) were analyzed. For the intervention group, there was a 16% reduction in all visits to the hospital (quotient, 1.88 vs 2.24; estimate, 0.84; 95% confidence interval [CI], 0.72-0.99) and a 47% reduction in visits to the emergency department (quotient, 0.35 vs 0.66; estimate, 0.53; 95% CI, 0.37-0.75). Drug-related readmissions were reduced by 80% (quotient, 0.06 vs 0.32; estimate, 0.20; 95% CI, 0.10-0.41). After inclusion of the intervention costs, the total cost per patient in the intervention group was $230 lower than that in the control group.

Conclusion  If implemented on a population basis, the addition of pharmacists to health care teams would lead to major reductions in morbidity and health care costs.

Trial Registration  clinicaltrials.gov Identifier: NCT00661310

Author Affiliations: Division of Pharmacokinetics and Drug Therapy, Department of Pharmaceutical Biosciences (Ms Gillespie and Dr Hammarlund-Udenaes), and Department of Pharmacy (Dr Kettis-Lindblad), Uppsala University, and Hospital Pharmacy (Mss Gillespie and Alassaad) and Departments of Rheumatology (Dr Henrohn), Medicine (Drs Toss and Mörlin), and Clinical Pharmacology (Dr Melhus), University Hospital of Uppsala, Uppsala, Sweden; and Division of Cancer Studies, School of Medicine, King's College London, London, England (Dr Garmo).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

In This Issue of Archives of Internal Medicine
Arch Intern Med. 2009;169(9):827.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

All you need to read in the other general journals
BMJ 2009;338:b2003-b2003.
FULL TEXT