Evaluation of the Impact of a Collaboration Between Hospital and Community Pharmacists at Hospital Discharge

NCT06902779 | Recruiting

• 1 other identifier: ECHOPHARM
• Study Type: interventional
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to evaluate the impact of an enhanced collaboration between a hospital pharmacist and a community pharmacist during hospital discharge. For patients taking multiple medications, hospitalization often involves numerous changes to their treatment regimen. For community pharmacies, discharge prescriptions are often complex, and they sometimes lack the information that pharmacists need to deliver the treatment as safely as possible. As a result, there is a risk of medication errors, and a risk for patients. We aim to evaluate the benefits of this collaboration for adult patients admitted to the internal medicine ward of a regional hospital who are taking seven or more drugs and are being discharged to home. The main question it aims to answer is : Does the enhanced collaboration reduce the number of drug-related problems encountered by community pharmacists with discharge prescriptions ? Researchers will compare patients when a hospital pharmacist is involved during the discharge process and when he or she is not involved, which corresponds to normal care. The hospital pharmacist will not perform the intervention directly on the patient, but only with the community pharmacy. Once they agree to participate in the study, patients will only have to go to their usual community pharmacy after discharge and accept that the hospital transmits medical information to their usual pharmacy.

Conditions

Polypharmacy

Keywords

transition of care; pharmacists; hospital discharge; collaboration

Outcome Measures

Primary Outcomes (1)

• Number of drug-related problems on the hospital discharge prescription

  Community pharmacists will assess the number of drug-related problems (DRP) on the discharge that they faced when preparing the discharge medication. They will have to use the PharmDISC system, which is a validated tool for referencing drug-related problems faced in the community which was adapted from the drug-related problems classification system of the Pharmaceutical Care Network Europe (PCNE). Community pharmacists will also document the intervention performed for each DRP, and the resolution (yes/no) of the DRP.

  7 days after hospital discharge

Secondary Outcomes (3)

• Patient's satisfaction

  7 days after hospital discharge

• Community pharmacists' satisfaction

  Through study completion, approximately 6 months

• 30 day readmission rate

  30 days after hospital discharge

Study Arms (2)

Control arm

NO INTERVENTION

Participants in the control arm will benefit from the usual standard of care currently provided in routine clinical practice. Physicians performs medication reconciliation on their own and hand-out the prescription to the patient the day of discharge. The patient then goes to the pharmacy for a classical drug dispensation.

Intervention arm

EXPERIMENTAL

Participants in the intervention group will benefit from the hospital pharmacist's support to optimize medication management and ensure a safe and effective discharge process.

Other: Support of the hospital pharmacist for the medication management at hospital discharge

Interventions

Support of the hospital pharmacist for the medication management at hospital discharge OTHER

1\) The hospital pharmacist calls the community pharmacy the day before discharge to order unusual or specific medications 2) The day of discharge, the hospital pharmacist performs a medication reconciliation in collaboration with the hospital physician 3) Once completed, the discharge prescription is sent to the community pharmacy before the patient is discharged. 4) The hospital pharmacist calls the community pharmacy to provide additional information about the patient and the prescription and to answer any questions. Additional information will help the community pharmacist to understand the prescription : administrative data, clinical data, medication-related information, patient follow-up and patient concerns.

Intervention arm

Eligibility Criteria

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

You may qualify if:

• Patients admitted to the internal medicine ward for more than 48 hours
• Patients prescribed seven or more drugs at the time of screening
• Patients discharged to home
• Patients able to give informed consent as documented by signature

You may not qualify if:

• Patient discharged to another hospital, nursing home or rehabilitation clinic
• Refusal of the community pharmacy to participate
• Inability to sign consent and follow the procedures of the study, due to language problems, psychological disorders, dementia, alterations of consciousness and lack of judgement

Sponsors & Collaborators

• Pharmacie des Hopitaux de l'Est Lemanique: lead

Study Sites (1)

Hôpital Riviera-Chablais, Vaud-Valais

Rennaz, Canton of Vaud, 1847, Switzerland

RECRUITING

Related Publications (15)

• Michel B, Hemery M, Rybarczyk-Vigouret MC, Wehrle P, Beck M. Drug-dispensing problems community pharmacists face when patients are discharged from hospitals: a study about 537 prescriptions in Alsace. Int J Qual Health Care. 2016 Dec 1;28(6):779-784. doi: 10.1093/intqhc/mzw111.

  PMID: 27655792 BACKGROUND

• Braund R, Coulter CV, Bodington AJ, Giles LM, Greig AM, Heaslip LJ, Marshall BJ. Drug related problems identified by community pharmacists on hospital discharge prescriptions in New Zealand. Int J Clin Pharm. 2014 Jun;36(3):498-502. doi: 10.1007/s11096-014-9935-8. Epub 2014 Apr 4.

  PMID: 24700340 BACKGROUND

• Imfeld-Isenegger TL, Studer H, Ceppi MG, Rosen C, Bodmer M, Beeler PE, Boeni F, Haring AP, Hersberger KE, Lampert ML. Detection and resolution of drug-related problems at hospital discharge focusing on information availability - a retrospective analysis. Z Evid Fortbild Qual Gesundhwes. 2021 Nov;166:18-26. doi: 10.1016/j.zefq.2021.08.004. Epub 2021 Sep 15.

  PMID: 34538579 BACKGROUND

• Ahmad A, Mast MR, Nijpels G, Elders PJ, Dekker JM, Hugtenburg JG. Identification of drug-related problems of elderly patients discharged from hospital. Patient Prefer Adherence. 2014 Feb 4;8:155-65. doi: 10.2147/PPA.S48357. eCollection 2014.

  PMID: 24523581 BACKGROUND

• Maes KA, Studer H, Berger J, Hersberger KE, Lampert ML. Documentation of pharmaceutical care: Validation of an intervention oriented classification system. J Eval Clin Pract. 2017 Dec;23(6):1425-1432. doi: 10.1111/jep.12817. Epub 2017 Sep 29.

  PMID: 28960678 BACKGROUND

• Mekonnen AB, McLachlan AJ, Brien JA. Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis. J Clin Pharm Ther. 2016 Apr;41(2):128-44. doi: 10.1111/jcpt.12364. Epub 2016 Feb 23.

  PMID: 26913812 BACKGROUND

• McCarthy LM, Li S, Fernandes O, Cameron K, Lui P, Wong G, Pariser P, Farrell J, Luke MJ, Guilcher SJT. Enhanced communication between inpatient and community pharmacists to optimize medication management during transitions of care. J Am Pharm Assoc (2003). 2019 Jan-Feb;59(1):79-86.e1. doi: 10.1016/j.japh.2018.09.006. Epub 2018 Nov 13.

  PMID: 30446423 BACKGROUND

• Bruhwiler LD, Hersberger KE, Lutters M. Hospital discharge: What are the problems, information needs and objectives of community pharmacists? A mixed method approach. Pharm Pract (Granada). 2017 Jul-Sep;15(3):1046. doi: 10.18549/PharmPract.2017.03.1046. Epub 2017 Aug 25.

  PMID: 28943987 BACKGROUND

• Grandchamp S, Blanc AL, Roussel M, Tagan D, Sautebin A, Dobrinas-Bonazzi M, Widmer N. Pharmaceutical Interventions on Hospital Discharge Prescriptions: Prospective Observational Study Highlighting Challenges for Community Pharmacists. Drugs Real World Outcomes. 2022 Jun;9(2):253-261. doi: 10.1007/s40801-021-00288-x. Epub 2021 Dec 31.

  PMID: 34971408 BACKGROUND

• Redmond P, Grimes TC, McDonnell R, Boland F, Hughes C, Fahey T. Impact of medication reconciliation for improving transitions of care. Cochrane Database Syst Rev. 2018 Aug 23;8(8):CD010791. doi: 10.1002/14651858.CD010791.pub2.

  PMID: 30136718 BACKGROUND

• Ensing HT, Stuijt CC, van den Bemt BJ, van Dooren AA, Karapinar-Carkit F, Koster ES, Bouvy ML. Identifying the Optimal Role for Pharmacists in Care Transitions: A Systematic Review. J Manag Care Spec Pharm. 2015 Aug;21(8):614-36. doi: 10.18553/jmcp.2015.21.8.614.

  PMID: 26233535 BACKGROUND

• Mekonnen AB, McLachlan AJ, Brien JA. Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: a systematic review and meta-analysis. BMJ Open. 2016 Feb 23;6(2):e010003. doi: 10.1136/bmjopen-2015-010003.

  PMID: 26908524 BACKGROUND

• Villeneuve Y, Courtemanche F, Firoozi F, Gilbert S, Desbiens MP, Desjardins A, Dinh C, LeBlanc VC, Attia A. Impact of pharmacist interventions during transition of care in older adults to reduce the use of healthcare services: A scoping review. Res Social Adm Pharm. 2021 Aug;17(8):1361-1372. doi: 10.1016/j.sapharm.2020.11.006. Epub 2020 Nov 13.

  PMID: 33250364 BACKGROUND

• Banholzer S, Dunkelmann L, Haschke M, Derungs A, Exadaktylos A, Krahenbuhl S, Liakoni E. Retrospective analysis of adverse drug reactions leading to short-term emergency hospital readmission. Swiss Med Wkly. 2021 Jan 20;151:w20400. doi: 10.4414/smw.2021.20400. eCollection 2021 Jan 18.

  PMID: 33516159 BACKGROUND

• Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003 Feb 4;138(3):161-7. doi: 10.7326/0003-4819-138-3-200302040-00007.

  PMID: 12558354 BACKGROUND

Study Officials

• Anne-Laure Blanc, PharmD, PhD

  Pharmacie des Hôpitaux de l'Est Lémanique

  STUDY DIRECTOR

Central Study Contacts

Paul Garin, PharmD

CONTACT

+41 79 534 21 36; paul.garin@phel.ch

Anne-Laure Blanc, PharmD, PhD

CONTACT

+41 58 773 45 43; annelaure.blanc@phel.ch

Study Design

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

Study Record Dates

• First Submitted: March 11, 2025
• First Posted: March 30, 2025
• Study Start: September 1, 2025
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): October 1, 2026
• Last Updated: April 16, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: IPD data will be available 6 months after publication of the first study results and for 10 years
• Access Criteria: Data will be accessible to external researchers, regulatory bodies, and authorized entities under the following conditions: Formal request submission detailing the project and data usage. Access granted if the request meets ethical, scientific, and confidentiality criteria.

Locations

CH (1)