Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities

NCT05241951 | Completed DMC

• 2 other identifiers: STUDY000110181R01HS027805
• Study Type: interventional
• Target: 1,052
• Locations: 1 country
• Sites: 1

Brief Summary

The Pharmacy Integrated Transitions (PIT) program, utilizes a crossover randomized control design to evaluate the impact of a clinical pharmacist in decreasing medication related problems during a patient's transition from hospital to skilled nursing facility (SNF).

Conditions

Care Transition

Keywords

Care Transition; Medication-Related Problems; Post-Acute Care; Skilled Nursing Facility; Hospital Systems; Medication Safety

Outcome Measures

Primary Outcomes (1)

• Medication Related Problems

  Number of medication related problems experienced by patients within 30 days post hospital discharge.

  30 days post hospital discharge

Secondary Outcomes (2)

• Death

  30 Days post hospital discharge

• Readmissions

  30 Days

Study Arms (2)

Clinical Pharmacist in Transition of Care

EXPERIMENTAL

A clinical pharmacist will be provided as a patient discharges from one of four University of Washington (UW) medical centers to one of 14 post acute skilled nursing facilities randomized to the intervention arm. The coordinating transitional pharmacist will conduct (1) a comprehensive medication review including medication reconciliation, adjustment, and monitoring during the transitional period from hospital to SNF, 2) a structured handoff between clinical teams at the hospital and SNF.

Other: Structured hand-off; Other: Medication reconciliation during transitional period; Other: Transitional medication monitoring; Other: Teleconsultation

Patient transitions from hospital to post-acute care

NO INTERVENTION

Patient will transition from one of four University of Washington (UW) medical centers to one of 14 post-acute skilled nursing facilities randomized to the control arm. Patients will receive the standard discharge process.

Interventions

Structured hand-off OTHER

Use of standardized checklist to provide synchronous or asynchronous handoff that conveys medication recommendations to the SNF clinical teams

Also known as: Standardized Checklist

Clinical Pharmacist in Transition of Care

Medication reconciliation during transitional period OTHER

Comprehensive medication reconciliation conducted during transitional period between hospital and SNF, focused on SNF-specific requirements for medication delivery (e.g., stop dates, titration instructions)

Clinical Pharmacist in Transition of Care

Transitional medication monitoring OTHER

Review of medication orders during first 7 days of SNF admittance to address barriers to translation of medication orders and appropriate medication delivery

Clinical Pharmacist in Transition of Care

Teleconsultation OTHER

Ad hoc consultation to provide additional clarification to SNF clinical teams

Clinical Pharmacist in Transition of Care

Eligibility Criteria

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

You may qualify if:

• years of age and older
• patients receiving inpatient care at University of Washington Mountlake, University of Washington Northwest, Harborview, and Valley Medical Center hospitals to one of 14 collaborating SNF's on a day when the PIT program pharmacist is conducting the intervention

You may not qualify if:

• Under 18 years of age
• patients with a discharge on hospice care
• patients discharged on days that the pharmacist is not conducting the intervention

Sponsors & Collaborators

• University of Washington: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

University of Washington Health System

Seattle, Washington, 98105, United States

Location

Related Publications (1)

• Hantouli MN, Monsell SE, Davidson GH, Chaing J, Comstock B, Dervish AA, Gionet NJ, Howard S, Jimenez N, Kim C, Liberman M, Lindo EG, Marcum ZA, Ong TD, Serrano E, Simons K, Sun LS, Zaslavsky O, Austin E; PIT Collaborative. Pharmacy Integrated Transitions (PIT) trial: a protocol for a pragmatic cluster-randomised crossover trial. BMJ Open. 2024 Dec 31;14(12):e088786. doi: 10.1136/bmjopen-2024-088786.

  PMID: 39740951 DERIVED

Related Links

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MeSH Terms

Interventions

Remote Consultation

Intervention Hierarchy (Ancestors)

Referral and Consultation; Professional Practice; Organization and Administration; Health Services Administration; Telemedicine; Delivery of Health Care; Patient Care Management

Study Officials

• Giana Davidson, MD, MPH

  University of Washington

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, School of Medicine: Surgery

Model Details: A parallel cluster-randomized controlled crossover trial design, with randomization occurring at the skilled nursing facility cluster level. The trial is conducted across four hospitals and 14 independent SNFs in Washington State. SNF's are stratified by patient volume before randomly assigned to either the PIT program or usual care.

Study Record Dates

• First Submitted: January 28, 2022
• First Posted: February 16, 2022
• Study Start: January 31, 2022
• Primary Completion: March 1, 2024
• Study Completion: October 31, 2025
• Last Updated: November 24, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)