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Community pharmacy

Patients followed up by pharmacists after hospital discharge less likely to be readmitted, study finds

Research published in the International Journal of Pharmacy Practice has shown that patients who are followed up by community pharmacists after being discharged from hospital are less likely to be readmitted within 30 days.

Female pharmacist in a consulation with an older person


Just 8.5% (n=35) of the patients who were seen by a pharmacist during the study period were readmitted to hospital within 30 days

Patients followed up by a community pharmacist after being discharged from hospital are significantly less likely to be readmitted within 30 days, a study published in the International Journal of Pharmacy Practice (4 February 2020) has found.

Researchers from the Royal Cornwall Hospitals NHS Trust and the South West Academic Health Science Network (AHSN) followed 1,130 patients who were discharged from the hospital between January 2017 and October 2017.

They found that 365 patients were later followed up by a community pharmacist through the hospital’s transfer of care around medicines (TCAM) service. The remaining 765 patients who were not followed up served as the control group for the study.

Just 8.5% (n=35) of the patients who were seen by a pharmacist were readmitted to hospital within 30 days. This is a vast improvement compared with the control group, where 23.3% (n=178) of patients were readmitted within the same time frame.

The TCAM service, which has been running in various parts of England since 2014, allows hospitals to electronically refer patients to community pharmacies through through the PharmOutcomes system, so that pharmacists can follow up patients with a post-discharge consultation.

The consultations in Cornwall involved a range of interventions, with some patients receiving more than one. These included 175 medicines use reviews, 38 medicine home deliveries, 26 new medicine service reviews and 26 reviews of monitored dosage service arrangements. 

The researchers said that the evaluation of the TCAM service in Cornwall “h as provided further evidence to support previous findings that community pharmacy intervention post-discharge can lower hospital readmission rates”.

“Community pharmacists were well placed to provide an additional safety net, in addition to general practice, and carry out targeted intervention post-hospital discharge,” they added.

The study comes after the ‘community pharmacy contractual framework for 2019/2020 to 2023/2024’ announced the national rollout of “a medicines reconciliation service as part of a TCAM service” in July 2019.

An NHS England official then said in January 2020 that the medicines reconciliation service would become an “essential service” for pharmacy and is being discussed as part of the contractual package for 2020/2021.

Clare Howard, clinical lead for the AHSN medicines programme, told The Pharmaceutical Journal: “The findings from Cornwall add to the growing evidence base from Newcastle, North West England, Wessex and other AHSN areas around the country that TCAM referrals to community pharmacy on discharge from hospital reduces readmission rates”.

“This is important work — which the AHSN Network has been at the heart of implementing — to improve patient care, reduce the burden on our hospitals and, importantly, ensure that community pharmacy is able to play its full role in the medicines pathway.”

The AHSN, which initially led the rollout of TCAM, said the service has saved the health economy more than £50m by reducing in the number of hospital readmissions.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20207665

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