Medicine information helpline after hospitalization-a randomized trial: Impact on patient satisfaction, patient concerns about medicines and clinical outcome on patient safety.

BACKGROUND AND AIM: Hospitalization often leads to changes in patients' medicine which challenges a safe medication use after discharge. Medicine information helplines (MIHs) can be valuable for patients in overcoming these challenges. This study evaluates patient satisfaction with a newly established Danish hospital-based MIH for discharged patients. The MIH is operated by experienced pharmacists and a pharmacy technician, and the study explores how the service affects the patient's concerns and perception of safety in relation to their medication, followed by an assessment of the clinical impact of MIH on patient safety. METHOD: A randomized controlled study design was used in the present study. The study was registered at clinicaltrials.gov with the identification number NCT03829995. Participants were randomized 1:4 (50:200) into a control- and intervention group. Participants in the control group were offered standard care and those in the intervention group were offered access to the MIH. A telephone interview performed 2-4 weeks after discharge assessed patient satisfaction with the helpline and patient's feeling of safety in relation to medicine use (primary outcome). Data were analyzed using a Mann-Whitney U test. After case handling of each enquiry to the MIH, the cases were assessed with regard to medication-related problems (MRPs) and clinical impact of the MIH service was assessed (primary outcome). RESULTS: A total of 250 participants were included in the study and 152 participated in the telephone interviews (33 control and 119 intervention). Thirty-seven questions were enquired by 26 participants to the MIH. Of these, 8 were requested before the telephone interviews and these patients all expressed a high satisfaction with the MIH (score 4.57 +/- 0.73 on a 5-point scale). Most patients offered access to the MIH expressed that it increased the sense of safety in relation to their medicines (79%). However, comparing the control- and intervention group with regard to patient concerns and feeling of safety in relation to medicine use no differences were found. Evaluation of the enquiries revealed at least one MRP per enquiry, and in most cases the advice given were assessed to have a high- or moderate clinical significance. CONCLUSION: The MIH was appreciated by the participants, indicating that the MIH could be a valuable service for discharged patients in improving the sense of safety in relation to medication and alleviating MRPs. Providing easy access for patients to medicine information may contribute to patient safe medicine use after discharge.

Incorrect storage of medicines and potential for cost savings.

OBJECTIVE: Incorrect storage and handling of refrigerated medicines may result in destruction of medicines and financial loss for hospitals. At the Medicine Information Centre we receive and answer queries on drug-related issues. In this study we aimed to investigate and quantify savings made following advice supplied by the Medicine Information Centre in reply to queries regarding the incorrect storage of refrigerated medicines. METHODS: A retrospective study was conducted by systematically reviewing each drug when the cold chain had been impaired, in order to determine whether the drug could continue to be used, possibly with a shortened expiry date. Thus, by examining all cases of incorrect storage, the value of drugs that pharmacists advised could be used despite a broken cold chain, could be estimated. RESULTS: The Medicine Information Centre dealt with 171 cases concerning incorrect storage in 2013. Data show that advice from Medicine Information Centre pharmacists resulted medicine cost savings of DKK 13 million (approx. €1.7 million) in hospitals in the Capital Region for that year. CONCLUSIONS: Substantial savings can be made by seeking the advice of a team of information pharmacists regarding the incorrect storage of medicines.