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The impact of including a medication review in an integrated care pathway: a pilot study
  • +7
  • Anaïs Payen,
  • Claire Godard-Sebillotte,
  • Nadia Sourial,
  • Julien Soula,
  • David Verloop,
  • Marguerite-Marie Defebvre,
  • Corinne Dupont,
  • Delphine Dambre,
  • Antoine Lamer,
  • Jean-Baptiste Beuscart
Anaïs Payen
Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France,

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Claire Godard-Sebillotte
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Nadia Sourial
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Julien Soula
Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France,
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David Verloop
Agence Régionale de Santé Hauts-de-France, Lille, France
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Marguerite-Marie Defebvre
Agence Régionale de Santé Hauts-de-France, Lille, France
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Corinne Dupont
Agence Régionale de Santé Hauts-de-France, Lille, France
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Delphine Dambre
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Antoine Lamer
Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France,
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Jean-Baptiste Beuscart
Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France,
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Abstract

Objective: Our hypothesis was that the intervention would decrease (or at least not increase) the number of potentially inappropriate medications (PIMs) and the number of hospital readmissions within 30 days of discharge per hospital stay. Methods: A cohort of hospitalized older adults enrolled in the PAERPA integrated care pathway (the exposed cohort) was matched retrospectively with hospitalized older adults not enrolled in the pathway (unexposed cohort) between January 1st, 2015, and December 31st, 2018. It was an analysis of French health administrative database. The inclusion criteria for exposed patients were admission to an acute care department in general hospital, age 75 or over, at least three comorbidities or the prescription of diuretics or oral anticoagulants, discharge alive, and performance of a medication review. Results: For the study population (n=582), the mean ± standard deviation age was 82.9 ± 4.9, and 190 (65.3%) were women. Depending on the definition used, the overall median number of PIMs ranged from 2 [0;3] upon admission to 3 [0;3] at discharge. The intervention was not associated with a significant difference in the mean number of PIMs. Patients in the exposed cohort were half as likely to be readmitted to hospital within 30 days of discharge, relative to patients in the unexposed cohort. Conclusion: Our results show that a medication review was not associated with a decrease in the mean number of PIMs. However, the integrated care intervention including the medication review was associated with a reduction in the number of hospital readmissions at 30 days.
16 Nov 2021Submitted to British Journal of Clinical Pharmacology
24 Nov 2021Submission Checks Completed
24 Nov 2021Assigned to Editor
20 Dec 2021Reviewer(s) Assigned
18 Feb 2022Review(s) Completed, Editorial Evaluation Pending
26 Feb 2022Editorial Decision: Revise Minor
28 Mar 20221st Revision Received
29 Mar 2022Submission Checks Completed
29 Mar 2022Assigned to Editor
29 Mar 2022Review(s) Completed, Editorial Evaluation Pending
25 Apr 2022Editorial Decision: Revise Minor
16 May 20222nd Revision Received
17 May 2022Submission Checks Completed
17 May 2022Assigned to Editor
17 May 2022Review(s) Completed, Editorial Evaluation Pending
19 Jul 2022Editorial Decision: Revise Minor
05 Aug 20223rd Revision Received
10 Aug 2022Submission Checks Completed
10 Aug 2022Assigned to Editor
10 Aug 2022Review(s) Completed, Editorial Evaluation Pending
31 Aug 2022Editorial Decision: Accept
17 Oct 2022Published in British Journal of Clinical Pharmacology. 10.1111/bcp.15543