Authors (including presenting author) :
CY Chow(1), SH Wu(1), CMH Sin(2), CK Chow(1), CK Ma(1), PK Ma(1)
Affiliation :
(1) Department of Paediatrics and Adolescent Medicine, (2) Pharmacy Department, United Christian Hospital.
Introduction :
Patients and their families must understand the rationale on the use of antiepileptic medications and appropriate seizure management when they are discharged from hospitals so that the care of epilepsy can be optimised. Proactive discussions were made amongst the team, which included paediatric neurologists, nurses and clinical pharmacists, with readmission cases reviewed and analyzed. As a result, an enhanced programme was developed to improve the drug compliance and reduced the unplanned readmission to our paediatric epileptic patients and parents
Objectives :
To describe the medication reconciliation programme developed by the multidisciplinary team in order to improve paediatric epileptic patient’s service outcomes.
Methodology :
Our team developed three enhancements to improve the current service. For the first enhancement, team members performed clinical pathway to ensure that the drug in histories taken were accurate at each transition of care. The second enhancement was to provide medication counselling with distribution of tailor-made antiepileptic medicine information leaflets. These leaflets provided insightful information such as side effects, administration tips and other important advice. For the third enhancement, clinical pharmacists provided in-depth discharge counseling to patients and parents in order to improve the understanding on the use of antiepileptic medications and the compliance. If necessary, drug calendars were provided. A newly designed medication reconciliation service clinical workflow has been implemented in wards since July 2019.
Result & Outcome :
A total number of 16 cases underwent our programme during the period from July to September 2019. Analysis of the cases was as follow: i. The number of cases with existing diagnosis of epilepsy was 11 and the number of cases with newly diagnosed epilepsy was 5; ii. The gender and age distribution were– 0-3 years old: 3 female and 1 male; 4-11 years old: 2 female and 7 male; 12-18 years old: 2 female and 1 male; iii. 13 patients were counselled with one drug only; 1 patient was counselled with 2 drugs and 2 patients were counselled with 3 or more drugs; iv. 12 patients (75%) out of 16 patients completed all parts of medication reconciliation programs, 4 patients (25%) out of 16 case did not receive the additional counselling session for discharged patients, because they were discharged outside of the clinical pharmacy service hours; v. All 16 patients did not have any readmission within 3 months due to drug-related problems. For the ongoing improvement, telephone follow-ups 2 weeks after discharge by nurses were proposed so that facilitators or barriers to the disease management can be identified. Conclusion Multidisciplinary care with good drug education and counselling on daily activity and medication is essential to optimise patient’s well-being, parental confidence and convulsion management after discharge. We hope all these measures can improve the outcome and decrease the readmission rate of our paediatric epilepsy patients.
