Senior PharmAssist: Decreased Hospital Use with Enrollment in an Innovative Community-Based Program

OBJECTIVES: To evaluate changes in acute health services use of Senior PharmAssist participants. DESIGN: Retrospective analysis. SETTING: Community-based, nonprofit program in Durham County, North Carolina. PARTICIPANTS: Adults aged 60 and older with income of 200% of the federal poverty level or less who enrolled in the Senior PharmAssist program (N = 191) between August 1, 2011, and March 15, 2017. INTERVENTION: Medication therapy management (MTM), customized community referrals, Medicare insurance counseling, and medication copayment assistance provided by Senior PharmAssist. MEASUREMENTS: Primary outcomes were self-reported emergency department (ED) visits and hospital admissions in the previous year, assessed at baseline and every 6 months for up to 2 years. RESULTS: Mean number of ED visits declined over time (0.83 visits per year at baseline to 0.53 visits per year at 24 months, P = .002), as did the percentage of participants reporting an ED visit in the past year (49% at baseline to 31% at 24 months, P = .003). Mean hospital admissions also decreased (0.56 admissions per year at baseline to 0.4 admissions per year at 24 months, P = .02). There was no significant change in percentage of participants reporting a hospital admission in the past year (33% at baseline to 25% at 24 months, P = .23). CONCLUSION: Older adults who enrolled in a community-based program that helps them manage medications, connect with community resources, and overcome barriers to medication access experienced reductions in acute health services use

Public health medicine training in the European community : is there scope for harmonization?

Harmonization of training in public health medicine has received little attention in the European Community compared with clinical specialties. Although most countries have a formal training programme, programmes recognized at a European level exist only in France, Ireland and the United Kingdom. This paper describes the basis of mutual recognition at the European Community level and the programmes in each country. Although there are some important differences including duration of training, there are many similarities. Several existing programmes meet European Community standards or would do so with a little modification. If harmonization is to occur it is necessary for public health bodies to make representations to their appropriate national bodies, and for public health to develop a much closer relationship with the relevant specialist committees of the European Commission