Document Detail


Specialist medication review does not benefit short-term outcomes and net costs in continuing-care patients.
MedLine Citation:
PMID:  20817937     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: to evaluate specialist geriatric input and medication review in patients in high-dependency continuing care.
DESIGN: prospective, randomised, controlled trial.
SETTING: two residential continuing care hospitals. Participants: two hundred and twenty-five permanent patients. Intervention: patients were randomised to either specialist geriatric input or regular input. The specialist group had a medical assessment by a geriatrician and medication review by a multidisciplinary expert panel. Regular input consisted of review as required by a medical officer attached to each ward. Reassessment occurred after 6 months.
RESULTS: one hundred and ten patients were randomised to specialist input and 115 to regular input. These were comparable for age, gender, dependency levels and cognition. After 6 months, the total number of medications per patient per day fell from 11.64 to 11.09 in the specialist group (P = 0.0364) and increased from 11.07 to 11.5 in the regular group (P = 0.094). There was no significant difference in mortality or frequency of acute hospital transfers (11 versus 6 in the specialist versus regular group, P = 0.213).
CONCLUSION: specialist geriatric assessment and medication review in hospital continuing care resulted in a reduction in medication use, but at a significant cost. No benefits in hard clinical outcomes were demonstrated. However, qualitative benefits and lower costs may become evident over longer periods.
Authors:
George Pope; Noreen Wall; Catherine Mary Peters; Margaret O'Connor; Jean Saunders; Catherine O'Sullivan; Teresa M Donnelly; Thomas Walsh; Steven Jackson; Declan Lyons; David Clinch
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Publication Detail:
Type:  Journal Article     Date:  2010-09-04
Journal Detail:
Title:  Age and ageing     Volume:  40     ISSN:  1468-2834     ISO Abbreviation:  Age Ageing     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375655     Medline TA:  Age Ageing     Country:  England    
Other Details:
Languages:  eng     Pagination:  307-12     Citation Subset:  IM    
Affiliation:
Mid Western Regional Hospital, Clinical Age Assessment Unit, Limerick, Ireland.
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