Medication Adherence Clinical Trial
Official title:
Feasibility of Using a Telemedicine Medication Delivery Unit for Older Adults That Require Medication Assistance During Transition Form Hospital to Home
Care transition interventions have been successful in reducing medication-related problems and associated rehospitalization primarily by focusing on medication reconciliation conducted by trained healthcare professionals. Programs to improve the medication reconciliation process have largely been effective, but have limitations including the expense associated with recruiting, training, and retaining care transition healthcare professionals (e.g., nurses and nurse practitioners) the ability to provide services within a finite geographic area, and the retrospective nature of the reconciliation process which usually occurs in the home following hospital discharge. Our short-term objective is to use Pennsylvania Department of Aging resources to assess the feasibility of using a telemedicine medication delivery unit for frail older adults that require medication assistance in their home immediately following an acute hospitalization. As part of this feasibility assessment, the investigators will assess (1) recruitment process and procedures, (2) data collection procedures, (3) resource utilization, (4) drop-out rates, (5) acceptability and usability of the EMMA® telemedicine medication delivery unit, (6) medication adherence, and (7) medication-reconciliation errors during transition from hospital to home.
Care transition interventions have been successful in reducing medication-related problems
and associated re-hospitalization primarily by focusing on medication reconciliation
conducted by trained healthcare professionals. Medication reconciliation is the process of
identifying discrepancies in drug regimens prescribed in different care settings or at
different time points within the same setting, to inform prescribing decisions and prevent
medication-related problems, including medication errors (MEs) and adverse drug events
(ADEs). MEs and ADEs are particularly common during and following hospitalization, when
multiple changes to a patients' medication regimens may be accompanied by inadequate patient
education,\ follow-up, and continuity of care with primary care physicians and case
managers. As a result of these problems, as many as 42% of general medical patients
experience an ME or ADE after hospital discharge, with disproportionate impacts on older
adults with chronic medical conditions. Post-hospital ADEs can be expensive, as12% result in
an emergency department evaluation and 5% in readmission, which is associated with a
significant increase in healthcare resource utilization and further fragmentation in care.
Programs to improve the medication reconciliation process have largely been effective, but
have limitations including the expense associated with recruiting, training, and retaining
care transition healthcare professionals (e.g., nurses and nurse practitioners), the ability
to provide services within a finite geographic area, and the retrospective nature of the
reconciliation process, which usually occurs in the home following hospital discharge. The
investigators short-term objective is to use Pennsylvania Department of Aging resources to
assess the feasibility of using a telemedicine medication delivery unit for frail older
adults that require medication assistance in their home immediately following an acute
hospitalization. As part of this feasibility assessment, the investigators will assess
several methods and intervention-related components.
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Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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