The benefits of a hospital based community services liaison pharmacist

Objective: to investigate the benefits of a community services liaison pharmacist in addressing medication misuse in elderly patients, which occur on both admission and discharge. Design: completion of a medication history for each patient on admission by the community liaison pharmacist. On discharge updated medication record sheets were faxed to the patient's GP and community pharmacy; a survey of GPs' and community pharmacists' opinions who were involved in the study was carried out. Subjects and setting: 109 patients over the age of 60 on 4 or more medications admitted by the medical admissions unit of Antrim Area Hospital. Main outcome measures: medication related problems; GP and community pharmacist opinions of the service. Results: of the 109 patients, 61% had an incomplete medication history on admission, 21% of patients who brought their own drugs were not dealt with appropriately in hospital and 33% of discharged patients had medication-related problems. The service was felt to be very useful by GPs (80%) and community pharmacists (100%). A reduction in readmission rate of 2.4% was seen in these patients compared to the average for this age group. Conclusion: the community services liaison pharmacist produced benefits in terms of patient medication management, reduced readmission rates and wastage of patients' own drugs. A more detailed one-year study will now be carried out.