The Secure Messaging for Medication Reconciliation Tool (SMMRT) Trial

NCT02482025 | Completed Results

• 1 other identifier: IIR 14-059
• Study Type: interventional
• Target: 240
• Locations: 1 country
• Sites: 1

Brief Summary

Medication discrepancies, defined as unintentional differences found between patients' medical records and patients' reports of the medication they are taking, occur frequently after hospital discharge, predisposing to adverse drug events (ADEs), emergency department visits and readmissions. Resolving medication discrepancies - medication reconciliation - is mandated at every care transition, but little is known about intervention strategies to improve medication reconciliation in the post-discharge period, when patients may lack prompt access to primary care and are at high risk for ADEs. To address this gap, the investigators developed and pilot tested the Secure Messaging for Medication Reconciliation Tool (SMMRT), with a pharmacist communicating with Veterans to review medications and reconcile discrepancies after hospital discharge via Secure Messaging (SM), within My HealtheVet (MHV), VA's patient portal. The objectives of The SMMRT Trial are therefore To optimize the end-users' experience with SMMRT through usability testing and refinement of the tool; To conduct a randomized controlled trial (RCT) of usual care vs. usual care plus MHV Training vs. usual care plus MHV Training plus SMMRT to reduce hospital utilization; To evaluate how Veterans and staff perceived the impact of SMMRT on routine clinical practices and, specifically, on Veterans' interactions with their primary care providers.

Conditions

Drug-Related Side Effects and Adverse Reactions; Adverse Drug Events

Keywords

Medications; Hospitalization; Electronic medical records

Outcome Measures

Primary Outcomes (1)

• Medication Discrepancies

  Medication discrepancies (discrepancies between what the patient is taking and what is in the medical record) identified 30 days after hospitalization via telephone interview and review of medical record

  30 days after hospitalization

Secondary Outcomes (1)

• Hospital Utilization

  30 days

Study Arms (2)

Usual care

NO INTERVENTION

Usual care delivered at VA Boston

SMMRT

ACTIVE COMPARATOR

Receives Usual Care PLUS SMMRT Intervention

Other: SMMRT

Interventions

SMMRT OTHER

Includes My HealtheVet registration and enrollment

SMMRT

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Veterans age 18 years or older
• Having a VA primary care provider (PCP) at any VA facility in VISN-1
• Planned discharge home (as opposed to another facility)
• Computer and internet access
• Anticipated to be discharged with at least 5 medications.
• Having a VA PCP will be defined as having seen the provider within the past two years
• Planned discharge home will be ascertained from the Veteran's nurse; approximately 75% of VA Boston discharges are to home
• The nurse will also provide number of anticipated discharge medications

You may not qualify if:

• Cognitive impairment (as determined by the Callahan screener)

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

Boston, Massachusetts, 02130, United States

Location

Related Publications (1)

• Brady JE, Linsky AM, Simon SR, Yeksigian K, Rubin A, Zillich AJ, Russ-Jara AL. The Perceived Effectiveness of Secure Messaging for Medication Reconciliation During Transitions of Care: Semistructured Interviews With Patients. JMIR Hum Factors. 2022 Aug 3;9(3):e36652. doi: 10.2196/36652.

  PMID: 35921139 DERIVED

MeSH Terms

Conditions

Drug-Related Side Effects and Adverse Reactions

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders

Results Point of Contact

• Title: Steven R. Simon, MD
• Organization: VA Greater Los Angeles Healthcare System

steven.simon2@va.gov

310.268.3132

Study Officials

• Amy M Linsky, MD MSc

  VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 23, 2015
• First Posted: June 25, 2015
• Study Start: November 16, 2018
• Primary Completion: October 22, 2019
• Study Completion: June 10, 2020
• Last Updated: November 19, 2020
• Results First Posted: November 19, 2020

Record last verified: 2020-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)