Posted At Canada.com

BY : Pamela Fayerman

Throughout the Fraser Health region, pharmacists are visiting recently discharged hospital patients in their homes, where the health professionals are given permission to peek into medicine cabinets and kitchen cupboards to ensure the patients don't wind up back in hospital because of some medication error.

The innovative program is the only one of its kind in Canada and early results, based on a pilot project in White Rock, indicate that for members of the target group who get the home visits -- seniors prescribed more than six medications -- there are fewer hospital re-admissions and shorter hospital stays when there is a readmission. The University of B.C.-sponsored pilot project also showed that seniors made fewer trips to the emergency department after a pharmacist paid them a home visit.

On Tuesday, 83-year-old Surrey resident Gladys Osborne, who just spent a week in hospital, got a visit from pharmacist Carla Ambrosini. Osborne was taken to hospital by ambulance after she fainted. In hospital, she was diagnosed with a mild stroke. Although she feels well enough to live on her own, she still must take 11 different medications for various conditions, so she found the home visit helpful.

"I think it's a wonderful program because when you're a senior, sometimes you forget to take your pills, but she set them all up for me so I know what to take at what time of the day," Osborne said, of the pharmacist.

Ambrosini said clients are always appreciative of the attention and they are encouraged to call for a return visit if they encounter any problems.

Mits Miyata, clinical pharmacy manager for Fraser Health, said medication-related problems, which can include illness stemming from under-medicating, over-medicating, adverse reactions or interactions between drugs, cause as many as 25 per cent of hospital admissions in seniors. Up to three-quarters of those admissions could be prevented with the kind of intervention from the community-based medication management program, as it is called.

"There are all kinds of health regions calling us to find out more about our program so they can replicate it. In some places in Ontario, individual pharmacists are trying to do home visits, but our program is the only one of its kind, since it's so big and organized," said Miyata, who believes about 2,600 patients each year will benefit.

With a $500,000 annual budget, Miyata has so far hired a program coordinator and four pharmacists who visit seniors in Burnaby, White Rock, Abbotsford and Surrey. If a request for a bigger budget is granted, Miyata hopes to hire more pharmacists and extend the program to Chilliwack, Maple Ridge and Delta.

"For pharmacists, it is a fulfilling and rewarding job working directly with clients, especially ones who have never had the benefit of this kind of interaction," he said.

The pharmacist often discovers people are not taking their medications as prescribed or they are taking over-the-counter and herbal medications like echinacea, melatonin, and garlic, which may interact with their prescription medications.

Once in the seniors' homes, the pharmacists will look in the fridge, cupboards and medicine cabinet for evidence of a potential problem. At times pharmacists have made recommendations which conflict with the prescribing pattern of the patient's family doctor. Pharmacists' recommendations for alterations are faxed to the doctor's office and Miyata said 85 per cent of the time, doctors accept the recommendations.