Effect of a trAnSitional Pharmacist Intervention in geRiatric Inpatients on Hospitals Visits After dischargE

NCT04617340 | Completed

• 1 other identifier: S64758
• Study Type: interventional
• Target: 827
• Locations: 1 country
• Sites: 1

Brief Summary

A randomized controlled trial will be performed in geriatric inpatients to investigate the impact of a multifaceted clinical pharmacy intervention on health related outcomes.

Conditions

Drug-Related Side Effects and Adverse Reactions

Keywords

Older patients; Inappropriate prescribing; Clinical pharmacy

Outcome Measures

Primary Outcomes (1)

• Time to all-cause unplanned hospital visit after discharge.

  An unplanned hospital visit is defined as an unplanned hospital admission or an emergency department visit

  up to six months after discharge

Secondary Outcomes (12)

• General practitioners contacts

  Up to six months after discharge

• Mortality

  Up to six months after discharge

• Other types of hospital visits

  Up to six months after discharge

• Drug-related readmissions

  Up to six months after discharge

• Fall incidents

  Up to one month after discharge

Study Arms (2)

Usual care group

NO INTERVENTION

No pharmacist will be actively involved in the medication review, counseling or discharge and post-discharge procedure. In both groups the best possible preadmission drug list will be compiled for inpatients within 72 hours after admission to the geriatric ward. If potentially dangerous or life-threatening drug errors are observed in the usual care group, this will be communicated to the treating physician

Intervention group

EXPERIMENTAL

The clinical pharmacist-collaborative service in the intervention group comprises six steps based on the clinical pharmacy intervention proposal of Van der Linden et al (Drugs Aging 2020). The first three steps focus on optimizing the drug therapy of geriatric inpatients. The remaining steps target a safe transition from the hospital to the community.

Other: Multifaceted clinical pharmacy intervention

Interventions

Multifaceted clinical pharmacy intervention OTHER

1. Assessing patient and caregiver preferences 2. Medication reconciliation on admission 3. Performing a comprehensive medication review before discharge 4. Promoting safe transition 4.a. Compiling a patient friendly medication list 4.b.Optimizing communication with healthcare providers in primary care: 4.b.i.Providing a copy of the medication list for the community pharmacist 4.b.ii. Contacting the general practitioner by phone 4.b.iii. Contacting, if applicable the home care nurse or the nurse from the nursing home by phone. 5.A motivation interview will take place before discharge with patients and caregivers 6.Post-discharge follow-up: 6.a.Follow-up call to discuss potential drug therapy issues, therapy adherence and to resolve any pending issues 6.b.A telepharmacology service will be provided to primary healthcare professionals as a means to consult the ward-based clinical pharmacists and/or research team after discharge.

Intervention group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients admitted to one of the study wards under supervision of a geriatrician
• A written informed consent by the patient or his/her representative
• Discharged from the hospital

You may not qualify if:

• Admitted for a maximum of one day
• Unable to understand Dutch
• Being in a palliative stage as stated in their medical record with active withdrawal of drug therapy
• Patients being discharged to another ward within the same hospital or to another hospital

Sponsors & Collaborators

• Universitaire Ziekenhuizen KU Leuven: lead

Study Sites (1)

University Hospitals Leuven

Leuven, Belgium

Location

Related Publications (3)

• Van der Linden L, Hias J, Walgraeve K, Flamaing J, Tournoy J, Spriet I. Clinical Pharmacy Services in Older Inpatients: An Evidence-Based Review. Drugs Aging. 2020 Mar;37(3):161-174. doi: 10.1007/s40266-019-00733-1.

  PMID: 31919802 BACKGROUND

• Hellemans L, Blocquiaux L, Hias J, Walgraeve K, Liesenborghs A, Lammens A, Deschodt M, Tournoy J, Van der Linden L. Effect of a Multifaceted Pharmacist-Led Intervention on Medication Appropriateness and Medication Burden in Patients Admitted to an Acute Geriatric Ward: Results from the ASPIRE Trial. Drugs Aging. 2026 Jan 31. doi: 10.1007/s40266-026-01278-w. Online ahead of print.

  PMID: 41619153 DERIVED

• Hias J, Hellemans L, Laenen A, Walgraeve K, Liesenborghs A, De Geest S, Luyten J, Spriet I, Flamaing J, Van der Linden L, Tournoy J. The effect of a trAnSitional Pharmacist Intervention in geRiatric inpatients on hospital visits after dischargE (ASPIRE): Protocol for a randomized controlled trial. Contemp Clin Trials. 2022 Aug;119:106853. doi: 10.1016/j.cct.2022.106853. Epub 2022 Jul 14.

  PMID: 35842106 DERIVED

MeSH Terms

Conditions

Drug-Related Side Effects and Adverse Reactions

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders

Study Officials

• Jos Tournoy, prof

  Department of Public Health and Primary care, KU Leuven, Leuven

  PRINCIPAL INVESTIGATOR

Study Design

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

Model Details: Randomized controlled trial

Study Record Dates

• First Submitted: October 29, 2020
• First Posted: November 5, 2020
• Study Start: February 25, 2021
• Primary Completion: September 27, 2024
• Study Completion: September 27, 2024
• Last Updated: April 16, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

BE (1)