Do clinical pharmacy activities have an impact on the re-hospitalization rate of elderly patients admitted in an Elderly Emergency Medicine (EMM) unit for fall?

• Published in: Gériatrie et psychologie neuropsychiatrie du vieillissement Vol. 19; no. 1; pp. 53 - 61
• Main Authors: Clementz, Alice, Jost, Jérémy, Lacour, Aurore, Ratsimbazafy, Voa, Tchalla, Achille
• Format: Journal Article
• Language: French
• Published: France 01.03.2021
• Subjects: rehospitalization; clinical pharmacy; fall; emergency department; elderly
• ISSN: 2115-7863
• DOI: 10.1684/pnv.2021.0916

To evaluate the effect of clinical pharmacy interventions on the unplanned rehospitalizations rates of elderly people admitted for fall to the elderly emergency medicine (EEM) unit in a teaching hospital. This was a longitudinal, comparative pilot study. Patients aged at least 75 who were admitted to the EEM unit for a fall and who had at least two chronic diseases and who were being treated with two or more medications were included from February 1, 2018 to June 30, 2018 and followed by 90 days. The main outcomes were the unplanned rehospitalizations rate at Limoges Teaching Hospital within the 90 days (primary outcome), 30 days and 72 hrs. The estimated cost-saving was also assessed. We included 252 patients. The mean age was 88.4 ± 5.8 years and the average baseline number of medications was 8.3 ± 3.4. In total, 158 pharmaceutical interventions were performed, reflecting an acceptance rate of 94.9%. We found a significant reduction of the rate of unplanned rehospitalizations at 90-day (OR = 0.45 (0.26-0.79) p = 0.005). These results were still consistent at 30-day (p = 0.035) and 72 hours (p = 0.041). We found a cost-saving of 37,770 euros related to 21 avoided rehospitalizations. Our results highly emphasize the positive effects of clinical pharmacy services on the prevention of unplanned rehospitalizations of old adults admitted for fall.