Medication Reconciliation at Discharge: Impact on Patient's Care

NCT03029052 | Completed DMC

• 1 other identifier: 2016-A01628-43
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

Patient's discharge from hospital is associated with iatrogenic events for 12 to 17% of patients. This risk may be linked with discontinuity of care between hospital physicians and Primary Care Physician (PCP). The investigators aim to assess in this study the impact of medication reconciliation at discharge associated with a patient's counseling session, both provided by a pharmacist, on patient's care after discharge. To demonstrate the interest of medication reconciliation at discharge we expect a reduction by 15% of the number of prescription changes not maintained by the PCP after discharge.

Conditions

Medication Reconciliation

Outcome Measures

Primary Outcomes (1)

• Proportion of in-hospital prescription changes not maintained by the Primary Care Physician (PCP) one month after discharge.

  The number of in-hospital prescription changes will be evaluated only on discharge prescription transmitted to the patient (after prescription analysis by a clinical pharmacist in the "reconciliation" group) Compared to the list of all current medications at admission, in-hospital prescription changes include the following: * Adding a new drug * Discontinuing a drug * Drug switch * Modifying a dose Among these hospital prescription changes, some will not be maintained by the PCP one month after discharge. In-hospital prescription changes not maintained by the PCP will be evaluated on the first prescription of the PCP following discharge.

  1 month

Study Arms (2)

Control group

NO INTERVENTION

Medical and pharmaceutical management (at admission, during hospitalization and at discharge) will follow standard healthcare procedures of the department.

Reconciliation group

EXPERIMENTAL

Standard healthcare procedures and pharmacist's involvement

Behavioral: Reconciliation

Interventions

Reconciliation BEHAVIORAL

In addition to standard healthcare procedures, the pharmacist will analyze discharge prescriptions and proceed to medication reconciliation. A patient's counseling session will also be provided by the pharmacist. A reconciliation mail will be addressed to the PCP.

Reconciliation group

Eligibility Criteria

• Age: 18 Years - 100 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age ≥ 18 years old
• hospitalized in infectious disease department
• with a chronic disease and a current medical prescription including at least three drugs
• discharged home or nursing home
• not opposed to the study

You may not qualify if:

• foreigners, patients under legal guardianship
• advanced dementia (MMS\<20) or phone tracking impossible
• primary care physician opposed to answer questionnaire

Sponsors & Collaborators

• Centre d'Investigation Clinique et Technologique 805: lead

Study Sites (1)

Hôpital Raymond poincaré

Garches, 92150, France

Location

MeSH Terms

Interventions

Medication Reconciliation

Intervention Hierarchy (Ancestors)

Medication Errors; Drug Therapy; Therapeutics; Medical Errors; Health Services; Health Care Facilities Workforce and Services; Medication Systems; Organization and Administration; Health Services Administration; Patient Care Management

Study Officials

• Frederique BOUCHAND, PharmD

  APHP

  PRINCIPAL INVESTIGATOR

• Benjamin DAVIDO, MD

  APHP

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PharmD

Model Details: Monocenter, randomized, controlled, pilot study.

Study Record Dates

• First Submitted: January 20, 2017
• First Posted: January 24, 2017
• Study Start: February 8, 2017
• Primary Completion: July 2, 2019
• Study Completion: July 2, 2019
• Last Updated: July 14, 2020

Record last verified: 2020-07

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)