Abstract：
OBJECTIVE: to evaluate the effect of clinical pharmacy interventions on the unplanned rehospitalisation rates of elderly people admitted following a fall to the emergency medical treatment for the elderly unit (médecine d\'urgence de la personne âgée [MUPA]) in a teaching hospital.
METHODS: this was a longitudinal, comparative pilot study. Patients aged at least 75 who were admitted to the MUPA unit following a fall, who had at least two chronic diseases, and who were being treated with two or more medications were included between 1 February 2018 and 30 June 2018 and were followed for 90 days. The main outcomes were the unplanned rehospitalisation rate at Limoges Teaching Hospital within the 90 days (primary outcome), 30 days and 72 h. The estimated cost-saving was also assessed.
RESULTS: 252 patients were included. 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 in the rate of unplanned rehospitalisations at 90 days (OR = 0.45 (0.26-0.79) P = 0.005). These results were also consistent at 30 days (P = 0.035) and 72 h (P = 0.041). We found a cost-saving of €37770 related to 21 avoided rehospitalisations.
CONCLUSIONS: our results strongly emphasise the positive effects of clinical pharmacy services on the prevention of unplanned rehospitalisations of elderly patients admitted following a fall.
METHODS: this was a longitudinal, comparative pilot study. Patients aged at least 75 who were admitted to the MUPA unit following a fall, who had at least two chronic diseases, and who were being treated with two or more medications were included between 1 February 2018 and 30 June 2018 and were followed for 90 days. The main outcomes were the unplanned rehospitalisation rate at Limoges Teaching Hospital within the 90 days (primary outcome), 30 days and 72 h. The estimated cost-saving was also assessed.
RESULTS: 252 patients were included. 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 in the rate of unplanned rehospitalisations at 90 days (OR = 0.45 (0.26-0.79) P = 0.005). These results were also consistent at 30 days (P = 0.035) and 72 h (P = 0.041). We found a cost-saving of €37770 related to 21 avoided rehospitalisations.
CONCLUSIONS: our results strongly emphasise the positive effects of clinical pharmacy services on the prevention of unplanned rehospitalisations of elderly patients admitted following a fall.
摘要：
目的：评估临床药学干预措施对在教学医院接受老年单位（紧急医疗[MUPA]）急诊治疗后住院的老年人计划外再住院率的影响。
方法：这是纵向的，比较试点研究。年龄至少75岁的患者在跌倒后进入MUPA病房，至少有两种慢性疾病，纳入2018年2月1日至2018年6月30日期间接受两种或两种以上药物治疗的患者,并随访90天.主要结果是利摩日教学医院90天内的计划外再住院率（主要结果），30天和72小时。还评估了估计的成本节约。
结果：包括252例患者。平均年龄为88.4±5.8岁，平均基线用药数量为8.3±3.4。总的来说,进行了158次药物干预，反映了94.9%的接受率。我们发现90天时计划外再入院率显着降低（OR=0.45（0.26-0.79）P=0.005）。这些结果在30天(P=0.035)和72小时(P=0.041)时也是一致的。我们发现节省了37770欧元，这与21次避免了再次住院有关。
结论：我们的研究结果强烈强调了临床药学服务对预防跌倒后住院的老年患者计划外再入院的积极作用。
方法：这是纵向的，比较试点研究。年龄至少75岁的患者在跌倒后进入MUPA病房，至少有两种慢性疾病，纳入2018年2月1日至2018年6月30日期间接受两种或两种以上药物治疗的患者,并随访90天.主要结果是利摩日教学医院90天内的计划外再住院率（主要结果），30天和72小时。还评估了估计的成本节约。
结果：包括252例患者。平均年龄为88.4±5.8岁，平均基线用药数量为8.3±3.4。总的来说,进行了158次药物干预，反映了94.9%的接受率。我们发现90天时计划外再入院率显着降低（OR=0.45（0.26-0.79）P=0.005）。这些结果在30天(P=0.035)和72小时(P=0.041)时也是一致的。我们发现节省了37770欧元，这与21次避免了再次住院有关。
结论：我们的研究结果强烈强调了临床药学服务对预防跌倒后住院的老年患者计划外再入院的积极作用。
