Optimizing Medication Therapy for Patients Recently Discharged From Hospital

Chronic Disease Clinical Trial

Official title:

Optimizing Medication Therapy Outcomes for Complex Patients Transitioning From Acute to Primary Care

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT02888782
• Other study ID #: HREB-2016.221
• Status: Terminated
• Phase: N/A
• Start date: December 8, 2016
• Est. completion date: June 29, 2018

Study information

• Verified date: October 2018
• Source: Memorial University of Newfoundland
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Patients who are discharged from hospital can be overwhelmed when they suddenly have to manage new conditions or medications. These changes can be particularly difficult for people on many medications or with multiple health conditions. There is a real risk that this will lead to emergency room visits, hospital readmission, and even death. In addition to endangering patients, these adverse events are very costly to the healthcare system. The good news is that these events can be preventable if patients receive care that is better coordinated.

Patient-oriented research will be conducted to determine if a pharmacist-led medication therapy management service can improve health outcomes of 'medically complex' patients transitioning from acute to primary care in Newfoundland and Labrador (NL). This a more comprehensive service than their community pharmacist would normally provide. The program will use a new Pharmacist Clinic service to provide care and support which does not currently exist for patients in NL after they leave hospital. After discharge, patients will be randomly divided into two groups: one group will receive care as usual from their doctor; the other group will have their medications assessed by a clinic pharmacist within one week of hospital discharge along with their usual care from their doctor. The two groups will be compared to determine whether specialized pharmacist services after hospital discharge is satisfactory to patients/providers, improves patient health, and reduces emergency room visits, hospital readmissions, and repeat trips to the doctor. If successful, this project will help ensure that patients are taking the right medications in the right way, improving individual health and making better use of healthcare system resources.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 89
• Est. completion date: June 29, 2018
• Est. primary completion date: April 30, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 50 Years and older

Eligibility

Inclusion Criteria:

1. 50 years of age or older

2. Admitted to a General Medicine ward

3. Take 5 or more chronic medications

Exclusion Criteria:

1. Discharge to a long term care facility

2. Life expectancy less than 3 months

3. Have entered palliative care

4. Cognitive impairment (unless a responsible caregiver can provide consent and assist in participation)

5. Non-English speaking

6. Unable to provide informed consent

Related Conditions & MeSH terms

• Chronic Disease

Intervention

Other:
• Pharmacist Consultation

Locations

Country	Name	City	State
Canada	Health Sciences Center	Saint John's	Newfoundland and Labrador
Canada	St. Clares Mercy Hospital	St. John's	Newfoundland and Labrador

Sponsors (1)

Lead Sponsor	Collaborator
Memorial University of Newfoundland

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Patient Satisfaction Survey	Measured using a Likert scale questionnaire	Collected 3 - 6 months after study enrollment
Other	Pharmacist Satisfaction Survey	Measured using a Likert scale questionnaire	Collected at the end of study period (12-15 months)
Other	Physician Satisfaction Survey	Measured using a Likert scale questionnaire	Collected at the end of study period (12-15 months)
Other	Patient quality of life Short Form Health Survey	Measured using a Short Form Health Survey (SF-36)	Collected at time of hospital discharge
Other	Patient quality of life Short Form Health Survey	Measured using a Short Form Health Survey (SF-36)	Collected at 30, 60 and 90 days post hospital discharge
Primary	Composite Hospital Utilization Rate	A composite score of hospital readmission rate and ER visits	30 days post discharge
Secondary	Number of Emergency Room Visits		30 days post discharge
Secondary	Number of Emergency Room Visits		60 days post discharge
Secondary	Number of Emergency Room Visits		90 days post discharge
Secondary	Rehospitalization Rate		30 days post discharge
Secondary	Rehospitalization Rate		60 days post discharge
Secondary	Rehospitalization Rate		90 days post discharge
Secondary	Mortality Rate		30 days post discharge
Secondary	Mortality Rate		60 days post discharge
Secondary	Mortality Rate		90 days post discharge
Secondary	Frequency of Family Physician Visits		30 days post discharge
Secondary	Frequency of Family Physician Visits		60 days post discharge
Secondary	Frequency of Family Physician Visits		90 days post discharge