Collaborative Home Visits to Reduce Hospital Readmissions and Improve Medication Use During Transitions of Care

NCT02087072 | Withdrawn

• 1 other identifier: 2013H0185
• Study Type: observational
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

The primary objective is to develop a sustainable practice model emphasizing home visits by a collaborative physician and pharmacist team to decrease unplanned emergency department visits and hospital readmissions at 30 and 90 days for high-risk home bound patients. Secondary objectives include (1) tracking the number, type, and severity of adverse drug events (ADE) and potential adverse drug events (pADE) that occur following hospital discharge and (2) resolving any identified ADE and pADE within 7 days of hospital discharge. Adult patients will be scheduled for a home visit by the Healthy at Home Columbus program at the time of hospital discharge. The home visit will occur within 7 days of hospital discharge and will consist of a complete hospital and medication review by a physician or nurse practitioner and a pharmacist (including all lab tests, imaging studies, medication changes, and proposed plan of care at the time of discharge). The investigators hypothesize these home visits will reduce 30 and 90 days hospital readmission rates and ED visits. The number of emergency department visits and unplanned hospital readmissions will be tracked at 30 and 90 days following discharge from the hospitalization that led to study enrollment. A comparison cohort of patients discharged in the 12 months prior to study initiation will be used to compare the effectiveness of the home visit program. The number and type of adverse drug events (ADE) and potential adverse drug events (pADE) that occur during transitions of care will also be characterized. All ADE and pADE will be resolved during the initial home visit and will be classified based on severity. All ADE and pADE will be evaluated independently by two pharmacist reviewers; each reviewer will independently assign a severity rating to each ADE and pADE.

Conditions

Transitional Care Coordination; Home Visits

Keywords

home visits; transitions of care; pharmacist

Outcome Measures

Primary Outcomes (1)

• Hospital Readmission

  30 days

Secondary Outcomes (1)

• Emergency Department Visit

  30 days

Other Outcomes (2)

• Number of drug related problems identified

  30 days

• Type of drug related problems identified

  30 days

Study Arms (1)

Recently discharged homebound patients

Other: Collaborative visit with provider and pharmacist

Interventions

Collaborative visit with provider and pharmacist OTHER

Recently discharged homebound patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients will be selected from the OSU Healthy at Home program that have been recently discharged from the hospital.

You may qualify if:

• Adult patients discharged from the hospital in the last 7 days and with more than two chronic conditions and significant obstacles to accessing care in an office setting are eligible for study participation

You may not qualify if:

• Adult patients able to access care in an office setting.
• Adult patients discharged from the hospital greater than 7 days prior to the office visit.

Sponsors & Collaborators

• Ohio State University: lead
• American Society of Health-System Pharmacy Foundation: collaborator

Study Sites (1)

The Ohio State University Division of General Internal Medicine Martha Morehouse

Columbus, Ohio, 43221, United States

Location

MeSH Terms

Interventions

Pharmacists

Intervention Hierarchy (Ancestors)

Health Personnel; Health Care Facilities Workforce and Services

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Clinical Pharmacy

Study Record Dates

• First Submitted: March 12, 2014
• First Posted: March 14, 2014
• Study Start: October 1, 2013
• Primary Completion: December 1, 2014
• Study Completion: December 1, 2014
• Last Updated: September 30, 2022

Record last verified: 2022-09

Locations

US (1)