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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT04841863
Other study ID # IIBSP-COD-2019-46
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date April 2021
Est. completion date April 2023

Study information

Verified date April 2021
Source Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
Contact Ana Juanes Borrego, Doctor
Phone 932 91 90 00
Email ajuanes@santpau.cat
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the clinical impact of a program for the secondary prevention of drug-realted problems (DRP) focused on the patient empowerment through Digital Health in patients who visit the Emergency Department (ED) of the Hospital de la Santa Creu i Sant Pau (HSCiSP) for a health problem related to medication in terms of readmissions, revisits and quality of life.


Description:

After being infomed about the estudy and potential risks, all patients who meet the eligibility requirements and giving written informed consent, will be randomized. The project is structured in two consecutive phases. 1. st Phase: 3-month randomized pilot study. Patients will be randomized with a 1:1 distribution to be included in the Drug Code Active Patient or DCAP (intervention group) or to receive usual care (control group). The pilot study will confirm whether the proposed methodology is feasible to implement it on a large scale, as well as providing the information necessary to calculate the sample of patients according to the main objective of the study. 2. nd Phase: Randomized clinical trial lasting 18 months (6 of which will be recruitment and 12 months follow-up) following the methodology described for the pilot in a larger sample of patients until the calculated sample size is achieved.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 200
Est. completion date April 2023
Est. primary completion date October 2021
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Age greater than or equal to 18 years. - Visit ED for a DRP caused bu a drug of the ATC groups A, B, C or N. - Be independent for activities of daily living (equivalent to Barthel 100). - Have a Chalson Comorbidity Index 2 <= 3. - Not present cognitive impairment. - Be directly responsible for pharmacotherapy. - Have a mobile device compatible with the MyPlan mobile application and access to Wi-Fi or mobile data, enabling the use of the technology platform from home. Exclusion Criteria: - Important language barrier. - Impossibility of carrying out the necessary questionnaires or interviews defined in the methods of this study. - Mental pathology that makes the autonomous use of technology impossible or that represents a safety problem for the patient according to clinical criteria. - Patients not residing in the territory who cannot be followed-up later.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
MyPlan digital health platform
Inclusion in the active group involves the use of MyPlan digital health tool that aims to improve clinical-patient communication, enahnce patient empowerment, improve early detection of side effects and allows professionals to individualize interventions.
Other:
Satndard care
Inclusion in the control group do not involves the use of MyPlan digital health tool. Patients will receive the standard of care.

Locations

Country Name City State
Spain Hospital de la Santa Creu i Sant Pau Barcelona

Sponsors (1)

Lead Sponsor Collaborator
Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

Country where clinical trial is conducted

Spain, 

References & Publications (30)

Anglada-Martínez H, Martin-Conde M, Rovira-Illamola M, Sotoca-Momblona JM, Sequeira E, Aragunde V, Moreno MA, Catalan M, Codina-Jané C. Feasibility and Preliminary Outcomes of a Web and Smartphone-Based Medication Self-Management Platform for Chronically Ill Patients. J Med Syst. 2016 Apr;40(4):99. doi: 10.1007/s10916-016-0456-y. Epub 2016 Feb 12. — View Citation

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Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, Rogak L, Bennett AV, Dueck AC, Atkinson TM, Chou JF, Dulko D, Sit L, Barz A, Novotny P, Fruscione M, Sloan JA, Schrag D. Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial. J Clin Oncol. 2016 Feb 20;34(6):557-65. doi: 10.1200/JCO.2015.63.0830. Epub 2015 Dec 7. Erratum in: J Clin Oncol. 2016 Jun 20;34(18):2198. Erratum in: J Clin Oncol. 2019 Feb 20;37(6):528. — View Citation

Campins L, Serra-Prat M, Palomera E, Bolibar I, Martínez MÀ, Gallo P. Reduction of pharmaceutical expenditure by a drug appropriateness intervention in polymedicated elderly subjects in Catalonia (Spain). Gac Sanit. 2019 Mar - Apr;33(2):106-111. doi: 10.1016/j.gaceta.2017.09.002. Epub 2017 Nov 20. — View Citation

Castro I, Guardiola JM, Tuneu L, Sala ML, Faus MJ, Mangues MA. Drug-related visits to the emergency department in a Spanish university hospital. Int J Clin Pharm. 2013 Oct;35(5):727-35. doi: 10.1007/s11096-013-9795-7. Epub 2013 May 22. — View Citation

Chen CE, Harrington RA, Desai SA, Mahaffey KW, Turakhia MP. Characteristics of Digital Health Studies Registered in ClinicalTrials.gov. JAMA Intern Med. 2019 Jun 1;179(6):838-840. doi: 10.1001/jamainternmed.2018.7235. — View Citation

Comín-Colet J, Enjuanes C, Verdú-Rotellar JM, Linas A, Ruiz-Rodriguez P, González-Robledo G, Farré N, Moliner-Borja P, Ruiz-Bustillo S, Bruguera J. Impact on clinical events and healthcare costs of adding telemedicine to multidisciplinary disease management programmes for heart failure: Results of a randomized controlled trial. J Telemed Telecare. 2016 Jul;22(5):282-95. doi: 10.1177/1357633X15600583. Epub 2015 Sep 7. — View Citation

de la Torre-Díez I, López-Coronado M, Vaca C, Aguado JS, de Castro C. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review. Telemed J E Health. 2015 Feb;21(2):81-5. doi: 10.1089/tmj.2014.0053. Epub 2014 Dec 4. Review. — View Citation

Donaldson LJ, Kelley ET, Dhingra-Kumar N, Kieny MP, Sheikh A. Medication Without Harm: WHO's Third Global Patient Safety Challenge. Lancet. 2017 Apr 29;389(10080):1680-1681. doi: 10.1016/S0140-6736(17)31047-4. — View Citation

Eysenbach G; CONSORT-EHEALTH Group. CONSORT-EHEALTH: improving and standardizing evaluation reports of Web-based and mobile health interventions. J Med Internet Res. 2011 Dec 31;13(4):e126. doi: 10.2196/jmir.1923. — View Citation

Gheewala PA, Peterson GM, Curtain CM, Nishtala PS, Hannan PJ, Castelino RL. Impact of the pharmacist medication review services on drug-related problems and potentially inappropriate prescribing of renally cleared medications in residents of aged care facilities. Drugs Aging. 2014 Nov;31(11):825-35. doi: 10.1007/s40266-014-0208-y. — View Citation

Gomis-Pastor M, Roig Mingell E, Mirabet Perez S, Brossa Loidi V, Lopez Lopez L, Diaz Bassons A, Aretio Pousa A, Feliu Ribera A, Ferrero-Gregori A, Guirado Perich L, Mangues Bafalluy MA. Multimorbidity and medication complexity: New challenges in heart transplantation. Clin Transplant. 2019 Oct;33(10):e13682. doi: 10.1111/ctr.13682. Epub 2019 Aug 28. — View Citation

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Heron KE, Smyth JM. Ecological momentary interventions: incorporating mobile technology into psychosocial and health behaviour treatments. Br J Health Psychol. 2010 Feb;15(Pt 1):1-39. doi: 10.1348/135910709X466063. Epub 2009 Jul 28. Review. — View Citation

Koshman SL, Charrois TL, Simpson SH, McAlister FA, Tsuyuki RT. Pharmacist care of patients with heart failure: a systematic review of randomized trials. Arch Intern Med. 2008 Apr 14;168(7):687-94. doi: 10.1001/archinte.168.7.687. Review. — View Citation

Lancaster K, Abuzour A, Khaira M, Mathers A, Chan A, Bui V, Lok A, Thabane L, Dolovich L. The Use and Effects of Electronic Health Tools for Patient Self-Monitoring and Reporting of Outcomes Following Medication Use: Systematic Review. J Med Internet Res. 2018 Dec 18;20(12):e294. doi: 10.2196/jmir.9284. — View Citation

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Pérez Menéndez-Conde C, Bermejo Vicedo T, Delgado Silveira E, Carretero Accame E. Adverse drug reactions which provoke hospital admission. Farm Hosp. 2011 Sep-Oct;35(5):236-43. doi: 10.1016/j.farma.2010.08.003. Epub 2011 May 12. English, Spanish. — View Citation

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Ravn-Nielsen LV, Duckert ML, Lund ML, Henriksen JP, Nielsen ML, Eriksen CS, Buck TC, Pottegård A, Hansen MR, Hallas J. Effect of an In-Hospital Multifaceted Clinical Pharmacist Intervention on the Risk of Readmission: A Randomized Clinical Trial. JAMA Intern Med. 2018 Mar 1;178(3):375-382. doi: 10.1001/jamainternmed.2017.8274. — View Citation

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* Note: There are 30 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Clinical impact of a digitial health tool for secondary prevention of DRP focused on patient empowerment. Change in clinical impact during the follow-up time will be evaluated in terms of number of readmissions, number of revisits and quality of life (based on the result obtained in the EQ-5D-3L51 questionnaire) Baseline, 48h after discharge, 30-day and 90-day after discharge (in phase I, Pilot Trial)
Primary Clinical impact of a digitial health tool for secondary prevention of DRP focused on patient empowerment. Change in clinical impact during the follow-up time will be evaluated in terms of number of readmissions, number of revisits and quality of life (based on the result obtained in the EQ-5D-3L51 questionnaire) Baseline, 48h after discharge, 6-month and 12-month after discharge (in phase II, Clinical Trial)
Secondary Identify, classify, and quantify DRP that cause urgent care in a tertiary hospital in this patient population. Type of DRP that promotes ED visits characterized according to the three dimensions of the Third Consensus of Granada (Need, Effectiveness and Safety) Baseline
Secondary Identify risk factors for ED visits related to DRP Age, sex, social and familiar environment, blood presure (mmHg), heart frequency (bpm), Hb1Ac (%), pain (visual analog scale), weight (kg) and height (cm), chronic kidney disease, number of drugs at admission and at discharge, number of chronic health problems. Baseline
Secondary Identify which groups of drugs are more frequently associated to DRP Using ATC group classification Baseline
Secondary Change in the patient therapeutic adherence Active days on the MyPlan platform, functionalities used, number of queries made through platform messaging Baseline, 48h after discharge, 30-day and 90-day after discharge (in phase I, Pilot Trial)
Secondary Change in the patient therapeutic adherence Active days on the MyPlan platform, functionalities used, number of queries made through platform messaging Baseline, 48h after discharge, 6-month and 12-month after discharge (in phase II, Clinical Trial)
Secondary Mesure therapeutic complexity Using patient Medication Regimen Complexity Index (pMRCI-S) questionnaire Baseline
Secondary Identify predictive factors of a greater capacity for digital empowerment. Using the CAMBADOS questionnaire Baseline
Secondary Measure the usability and satisfaction of patients, caregivers and professionals of the MyPlan digital health tool Using the TrilemaSalud questionnaire 90-day after discharge (in phase I, Pilot Trial)
Secondary Measure the usability and satisfaction of patients, caregivers and professionals of the MyPlan digital health tool Using the TrilemaSalud questionnaire 12-month after discharge (in phase II, Clinical Trial)
Secondary Change in the quality of life of patients in the active group Using the EQ-5D-3L51 questionnaire Baseline, 30-day and 90-day after discharge (in phase I, Pilot Trial)
Secondary Change in the quality of life of patients in the active group Using the EQ-5D-3L51 questionnaire Baseline, 6-month and 12-month after discharge (in phase II, Clinical Trial)
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