Effects of an outpatient multifaceted medication review in older patients on the prevalence of emergency department visit and hospital admission

Abstract Background. The prevalence of medication related emergency department visit and acute hospital admission is significant in older patients due to the high prevalence of multimorbidity and associated polypharmacy. Aim. To explore whether a multifaceted outpatient medication review could alter the overall prevalence of an emergency department visit and acute hospital admission.Method. All new patients visiting our geriatric outpatient clinic had a multifaceted medication review (evaluation by a geriatrician, pharmacist and clinical decision support system). Subsequently we analysed the number of and reason for emergency department visit, acute hospital admission and readmission in the year prior to and following the index-date (date of first presentation and medication review).Results. The mean number of acute hospital admissions per patient in the year before and after medication review did not differ (0.3 ± 0.6 vs. 0.4 ± 0.6, p=0.153), as did the 30- and 180-day readmission rate (p=0.69 and p=0.83). There were no differences in reasons for acute hospital admission before and after medication review, but there was a significant difference in the number of potentially medication related emergency department visits (38.9 vs. 19.6%, p<0.01).Conclusion. There was no beneficial effect of an outpatient clinic multifaceted medication review on the overall rate of acute hospital admission or readmission during 12 months follow-up. There was however a reduction of 20% in potentially medication related emergency department visits after medication review.