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New transfer of care initiative of electronic referral from hospital to community pharmacy in England: a formative service evaluation
  1. Hamde Nazar1,
  2. Steven Brice2,
  3. Nasima Akhter3,
  4. Adetayo Kasim3,
  5. Ann Gunning4,
  6. Sarah P Slight1,
  7. Neil W Watson2
  1. 1School of Medicine, Pharmacy and Health, Durham University, Stockton-On-Tees, UK
  2. 2Pharmacy Department, Newcastle-upon-Tyne NHS Foundation Trust, Newcastle-upon-Tyne, UK
  3. 3Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton-on-Tees, UK
  4. 4Head of Services and Support, North of Tyne Local Pharmaceutical Committee, Newcastle-upon-Tyne, UK
  1. Correspondence to Dr Hamde Nazar; hamde.nazar{at}durham.ac.uk

Abstract

Objectives To evaluate an electronic patient referral system from one UK hospital Trust to community pharmacies across the North East of England.

Setting Two hospital sites in Newcastle-upon-Tyne and 207 community pharmacies.

Participants Inpatients who were considered to benefit from on-going support and continuity of care after leaving hospital.

Intervention Electronic transmission of an information related to patient's medicines to their nominated community pharmacy. Community pharmacists to provide a follow-up consultation tailored to the individual patient needs.

Primary and secondary outcomes Number of referrals made to and received by different types of pharmacies; reasons for referrals; accepted/completed and rejected referred rates; reasons for rejections by community pharmacists; time to action referrals; details of the follow-up consultations; readmission rates at 30, 60 and 90 days post referral and number of hospital bed days.

Results 2029 inpatients were referred over a 13-month period (1 July 2014–31 July 2015). Only 31% (n=619) of these patients participated in a follow-up consultation; 47% (n=955) of referrals were rejected by community pharmacies with the most common reason being ‘patient was uncontactable’ (35%, n=138). Most referrals were accepted/completed within 7 days of receipt and most rejections were made >2 weeks after referral receipt. Most referred patients were over 60 years of age and referred for a Medicines Use Review (MUR) or enrolment for the New Medicines Service (NMS). Those patients who received a community pharmacist follow-up consultation had statistically significant lower rates of readmissions and shorter hospital stays than those patients without a follow-up consultation.

Conclusions Hospital pharmacy staff were able to use an information technology (IT) platform to improve the coordination of care for patients transitioning back home from hospital. Community pharmacists were able to contact the majority of patients and results indicate that patients receiving a follow-up consultation may have lower rates of readmission and shorter hospital stays.

  • care transitions
  • health boundaries
  • information transfer
  • continuity of care

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Twitter Follow Hamde Nazar at @NazarHamde

  • Contributors NWW, AG and SB were involved in the design and implementation of the intervention. HN designed the service evaluation, and HN, NA and AK analysed the data. All authors discussed the results and interpretation. All authors were involved in drafting the initial text for the report and revising drafts prior to publication, and all approved the submission.

  • Funding This research has received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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