Pharmacy World and Science

, Volume 26, Issue 2, pp 114–120

Evaluation of a hospital-based community liaison pharmacy service in Northern Ireland


  • Helen Bolas
    • Antrim Area Hospital Academic Practice Unit, Antrim Area Hospital
  • Kasia Brookes
    • Antrim Area Hospital Academic Practice Unit, Antrim Area Hospital
  • Michael Scott
    • Antrim Area Hospital Academic Practice Unit, Antrim Area Hospital
  • James McElnay
    • School of PharmacyQueen's University Belfast

DOI: 10.1023/B:PHAR.0000018601.11248.89

Cite this article as:
Bolas, H., Brookes, K., Scott, M. et al. Pharm World Sci (2004) 26: 114. doi:10.1023/B:PHAR.0000018601.11248.89


Objective: To evaluate the impact of a hospital based community liaison pharmacy service on a range of outcomes in patients aged more than 55 years and taking more than 3 prescribed drugs, who had been admitted to the medical unit of a district general hospital in Northern Ireland.

Methods: Having recruited 243 patients, a total of 162 patients completed the full protocol (81 randomly assigned to intervention and 81 to control; mean age of control patients 75 years; mean age of intervention patients 73 years). The interventions by the community liaison pharmacist included: preparation of an accurate medication record following a full review of current medication use; medication counselling; provision of a medicines record sheet informing the patient how to take their drugs; provision of a pharmaceutical discharge letter detailing changes made to drug therapy (this was faxed to the patient's GP and community pharmacist on the day of discharge); provision of a Medicines Helpline.

Results: The key findings were as follows: problems were identified in 80% of the intervention patients' prescription charts, 49% of which related to drug omissions from the patients' domiciliary prescriptions. The GP practice record was the most accurate (mean error rate 12.6%) while the GP referral letter was the least accurate (mean error rate 47.3%) source of medication information. Drugs patients brought to hospital were also an inaccurate source (mean error rate 44.0%). The intervention group patients, when compared with control patients, had a significant reduction (P=0.005) in drug mismatch between drugs prescribed at discharge and taken at home, and had a greater knowledge of their drug regimen 10–14 days after discharge (P |Ld 0.001). The vast majority of patients (96%) felt that the provision of a medicine helpline was a useful service.

Conclusions: The study indicated clear benefits from the involvement of a hospital based community liaison pharmacist in achieving seamless pharmaceutical care between the primary and secondary healthcare settings.

Discharge planning Drug related problems Hospital admission Northern Ireland Patient counselling Seamless care

Copyright information

© Kluwer Academic Publishers 2004