New research shows hospital-to-pharmacy referrals cut readmissions

New research by the South West Academic Health Science Network (SW AHSN) in partnership with Royal Cornwall Hospitals NHS Trust (RCHT) has found involving community pharmacy when patients are discharged from hospital can help to prevent readmission.
The research, published earlier this month in the International Journal of Pharmacy Practice (4 February 2020), shows that patients who are followed up by community pharmacists after being discharged from hospital are less likely to be readmitted within 30 days.
When some patients leave hospital they need extra support taking their prescribed medicines safely and effectively. Under the Transfer of Care Around Medicines (TCAM) service – one of seven programmes chosen by the AHSN Network for spread and adoption across England – when patients discharged from hospital are identified as needing extra support they are referred through a safe and secure digital platform for advice from their local community pharmacist.
In South West England, the SW AHSN has been supporting local trusts like RCHT to establish a TCAM pathway. We supported the setup of a secure electronic interface between the hospital IT system and PharmOutcomes software in the community pharmacy, to enable patients to be referred to their community pharmacy or GP pharmacist where appropriate.
Researchers from the SW AHSN and RCHT followed 1,130 patients who were discharged from RCHT between January and October 2017. Of these patients, 365 were followed up by a community pharmacist through the hospital’s TCAM service. Just 8.5% of the patients who were seen by a pharmacist were readmitted to hospital within 30 days, compared to 23.3% of patients within the control group.
Patients followed up by pharmacists received one or more interventions, including 175 medicines use reviews, 38 medicine home deliveries, 26 new medicine service reviews, and 26 reviews of monitored dosage service arrangements.
The study comes after the Community pharmacy contractual framework for 2019/2020 to 2023/2024, published in July 2019, announced the national rollout of a medicines reconciliation service building on the TCAM pilots. This month, the UK government announced the new discharge service will enable hospitals across the country to digitally notify community pharmacies when patients who have been recently discharged may need advice on taking new medicines or changes to their prescriptions from July 2020. Community pharmacists will subsequently be expected to contact the patient for a consultation, to help reduce the likelihood of readmission to hospital.
Sarah Robens, co-author of the paper and evaluation lead at the SW AHSN, said: “I am thrilled that some of the earliest adopters of the TCAM service in Cornwall have produced an excellent piece of research with our SW AHSN colleagues, demonstrating the benefits of the service to patients and the system. This paper provides further evidence to support the continued spread of the service into new trusts and community pharmacies.”
The SW AHSN will continue to support local trusts and community pharmacies to implement TCAM in 20/21, ensuring patients across Somerset, Devon, Cornwall and the Isles of Scilly can benefit from the service.
Read the paper in full: https://doi.org/10.1111/ijpp.12603
Wilcock, M., Sibley, A., Blackwell, R., Kluettgens, B., Robens, S., Bastian, L., (4 February 2020) ‘Involving community pharmacists in transfer of care from hospital: Indications of reduced 30-day hospital readmission rates for patients in Cornwall.’ International Journal of Pharmacy Practice.