A major contributor to inadvertent polypharmacy and drug-related problems in the elderly appears to be hospitalisation and the consequent changes in medication at the transition from out-patient to in-patient care and back. This project will tackle this major issue of poor medication management, including non-compliance and adverse outcomes, in recently hospitalised patients. Comprehensive background data on these medication-related problems in discharged patients have been collected by members of our Team in several recent projects.
The project will implement and evaluate an innovative medication support program for high-risk patients. The program will utilise information and communications technology solutions and include
(i) an electronic communication pathway for medication profiles between community and hospital pharmacies,
(ii) supply of a comprehensive medication information sheet to the patient/carer at discharge,
(iii) automated faxing or encrypted emailing of the medication information sheet to the general practitioner at discharge,
(iv) a model whereby suitable patients are referred for a medicines review after discharge from hospital, incorporating an electronic alerting mechanism, and
(v) follow-up education and monitoring of the International Normalised Ratio for patients initiated on warfarin during hospitalisation. |
