Optimizing Medication Therapy for Patients Recently Discharged From Hospital

NCT02888782 | Terminated

• 1 other identifier: HREB-2016.221
• Study Type: interventional
• Target: 89
• Locations: 1 country
• Sites: 2

Brief Summary

Patients who are discharged from hospital can be overwhelmed when they suddenly have to manage new conditions or medications. These changes can be particularly difficult for people on many medications or with multiple health conditions. There is a real risk that this will lead to emergency room visits, hospital readmission, and even death. In addition to endangering patients, these adverse events are very costly to the healthcare system. The good news is that these events can be preventable if patients receive care that is better coordinated. Patient-oriented research will be conducted to determine if a pharmacist-led medication therapy management service can improve health outcomes of 'medically complex' patients transitioning from acute to primary care in Newfoundland and Labrador (NL). This a more comprehensive service than their community pharmacist would normally provide. The program will use a new Pharmacist Clinic service to provide care and support which does not currently exist for patients in NL after they leave hospital. After discharge, patients will be randomly divided into two groups: one group will receive care as usual from their doctor; the other group will have their medications assessed by a clinic pharmacist within one week of hospital discharge along with their usual care from their doctor. The two groups will be compared to determine whether specialized pharmacist services after hospital discharge is satisfactory to patients/providers, improves patient health, and reduces emergency room visits, hospital readmissions, and repeat trips to the doctor. If successful, this project will help ensure that patients are taking the right medications in the right way, improving individual health and making better use of healthcare system resources.

Conditions

Chronic Disease

Outcome Measures

Primary Outcomes (1)

• Composite Hospital Utilization Rate

  A composite score of hospital readmission rate and ER visits

  30 days post discharge

Secondary Outcomes (12)

• Number of Emergency Room Visits

  30 days post discharge

• Number of Emergency Room Visits

  60 days post discharge

• Number of Emergency Room Visits

  90 days post discharge

• Rehospitalization Rate

  30 days post discharge

• Rehospitalization Rate

  60 days post discharge

Other Outcomes (5)

• Patient Satisfaction Survey

  Collected 3 - 6 months after study enrollment

• Pharmacist Satisfaction Survey

  Collected at the end of study period (12-15 months)

• Physician Satisfaction Survey

  Collected at the end of study period (12-15 months)

Study Arms (2)

Pharmacist Consultation

EXPERIMENTAL

Meet with pharmacist for consultation in addition to regular physician follow up

Other: Pharmacist Consultation

Control

NO INTERVENTION

Receive regular physician follow up

Interventions

Pharmacist Consultation OTHER

Pharmacist Consultation

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• years of age or older
• Admitted to a General Medicine ward
• Take 5 or more chronic medications

You may not qualify if:

• Discharge to a long term care facility
• Life expectancy less than 3 months
• Have entered palliative care
• Cognitive impairment (unless a responsible caregiver can provide consent and assist in participation)
• Non-English speaking
• Unable to provide informed consent

Sponsors & Collaborators

• Memorial University of Newfoundland: lead

Study Sites (2)

Health Sciences Center

St. John's, Newfoundland and Labrador, Canada

Location

St. Clares Mercy Hospital

St. John's, Newfoundland and Labrador, Canada

Location

MeSH Terms

Conditions

Chronic Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Deborah Kelly, PharmD

  Memorial Univeristy of Newfoundland

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor and Special Advisor of Innovation

Study Record Dates

• First Submitted: August 25, 2016
• First Posted: September 5, 2016
• Study Start: December 8, 2016
• Primary Completion: April 30, 2018
• Study Completion: June 29, 2018
• Last Updated: October 9, 2018

Record last verified: 2018-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (2)