Swallowing Medicines: Collaborating to Improve Patient Outcomes
Ying Li Liang1, Alice Wisdom1, Trang Tran1, Phuong Doan1, Nicolette Varvounis, Kelly Keyte 1SA Pharmacy, Adelaide, South Australia, Australia
Abstract
Background: Changes in swallowing function commonly occurs in hospitalised patients with an acute illness and poses a high risk of medication complications including inappropriate formulation administration, dose omissions or delay.
Aim/Objective: To assess the incidence and timeliness of Pharmacy review and formulation modification following a change in swallowing status made by a Speech Pathologist.
Methods: An observational study was undertaken across two metropolitan hospitals between July and December 2020. Patients with modification to swallowing status made by a Speech Pathologist and details of Pharmacy review and interventions were recorded.
Results: Of the 96 patients identified for inclusion, 74% (71) received a pharmacy review following swallowing modification by a speech pathologist. The average time to the pharmacist review was 4.7 days (SD 5.2) with 97% (69/71) of patients seen during weekdays. Overall, 44% (42/96) required one or more modifications to their medicines. A pharmacy referral was documented for 27 patients (28%) of which all but 1 were made by the speech pathologist. The average time from swallowing modification to pharmacy review was significantly reduced when a formal referral was documented: 5.8 days vs 1.8 days, p=0.004.
Discussion: The incidence of early Pharmacist review following swallowing modification was low, with the absence of a direct referral being a barrier for early review and intervention to reduce the incidence of unnecessary medication omissions. Establishing a formalised documented referral pathway between Speech Pathology and Pharmacy is necessary to facilitate early intervention and minimise medication complications.
Biography
Trang is the current acting Deputy Director at Modbury Hospital and oversees both the clinical and dispensary team.