PharmD Transitions of Care Program (PHARMD-TOC): A Community Pharmacy Transitions of Care Program

NCT03617380 | Withdrawn

• 1 other identifier: 171847
• Study Type: interventional
• Target: N/A
• Locations: 0 countries
• Sites: N/A

Brief Summary

Many hospitals and medical groups have developed transitions of care (TOC) programs or procedures in an attempt to reduce hospital readmission and reutilization rates of patients discharged from the hospital. As healthcare's most accessible practitioners, Community Pharmacists have a unique opportunity to assist with reducing unnecessary hospital re-utilization (re-admissions and emergency department visits) after hospital discharge. The purpose of this study is to conduct and evaluate the implementation of a Community Pharmacy-based Transitions of Care (TOC) Program for high-risk post-discharge patients of PIH Health Hospital-Whittier (PIH). The primary objective will be to compare the proportion of patients with hospital re-utilization (readmission, observation status, ED visits) during 30-days post hospital discharge between patients randomly assigned to the PHARMD-TOC group vs. the historic rate at PIH. Secondary analyses will examine differences between groups and describe implementation details of the PHARMD-TOC model of patient care.

Conditions

Disease, Chronic

Outcome Measures

Primary Outcomes (1)

• Proportion Patients with Hospital Reutilization

  proportion of patients with hospital re-utilization (readmission, observation status, ED visits) during 30-days post hospital discharge

  30 days post hospital discharge

Study Arms (2)

PHARMD-TOC i

EXPERIMENTAL

PharmD Follow-Up Post Discharge

Other: PharmD TOC

USUAL CARE

ACTIVE COMPARATOR

Usual Post Discharge Procedures

Other: Usual Care

Interventions

Usual Care OTHER

patients participating Usual Care discharge services

USUAL CARE

PharmD TOC OTHER

patients participating in a community pharmacy-based Transitions of Care Program (PHARMD-TOC)

PHARMD-TOC i

Eligibility Criteria

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

You may qualify if:

• \- Admission LACE Score: in moderate range (5 to 9) And
• Taking high risk medication(s): anticoagulants, insulin, oral antiplatelet agents, oral hypoglycemic agents, opioid analgesics, digoxin Or Taking at least 5 medications AND have one of following: CHF, COPD, Asthma, Pneumonia, Diabetes, ESRD, Schizophrenia, Bi-Polar, Dizziness, History of Falls
• And
• Medical or Surgical Unit patients
• Age \> 18 years
• Being discharged to home (with or without Home Health services)
• English and/or Spanish speaking
• Will have access to a telephone post-discharge
• Ability to give consent
• Patient admitted to hospital through the emergency department, as a direct admission or as a transfer, or as an elective surgery patient

You may not qualify if:

• \- Patients with observation status
• Caremore Health Plan patients (Caremore has a separate post-discharge program)
• Patients discharged and followed up by the PIH Coumadin Clinic
• Patients discharged to Residential MD House Calls program
• Patients discharged to Skilled Nursing Facility
• Anyone with planned readmissions
• Obstetrics patients
• Hospice patients
• Oncology patients
• Anyone who does not meet provisions of protocol
• Anyone unwilling or unable to give consent for study procedures and data access

Sponsors & Collaborators

• University of California, San Diego: lead

MeSH Terms

Conditions

Chronic Disease

Condition Hierarchy (Ancestors)

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

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: Professor Clinical Pharmacy

Study Record Dates

• First Submitted: July 31, 2018
• First Posted: August 6, 2018
• Study Start: October 1, 2018
• Primary Completion: February 10, 2020
• Study Completion: February 10, 2020
• Last Updated: February 12, 2020

Record last verified: 2020-02