Effectiveness of Pre-Consultation Medication Reconciliation Service in Reducing Unintentional Medication Discrepancies During Transition of Care From Hospital Discharge to Primary Care Setting

Medication Adherence Clinical Trial

Official title:

Effectiveness of Pre-Consultation Medication Reconciliation Service in Reducing Unintentional Medication Discrepancies During Transition of Care From Hospital Discharge to Primary Care Setting- A Randomised Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03181906
• Other study ID #: DSRB2015/01219
• Status: Completed
• Phase: N/A
• First received: June 2, 2017
• Last updated: June 7, 2017
• Start date: March 11, 2016
• Est. completion date: April 30, 2017

Study information

• Verified date: June 2017
• Source: National Healthcare Group, Singapore
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study evaluates the the effectiveness of pre-consultation Medication Reconciliation Service in reducing unintentional medication discrepancies among patients who discharged from hospital to primary care.

Description:

Medication discrepancies during care transition were common. Many factors contribute to the risk of medication discrepancies. Despite medication reconciliation service being practiced in the hospital setting, there was limited knowledge on its effectiveness in the primary care setting. This study aims to evaluate the effectiveness of a pre-consultation medication reconciliation service in reducing medication discrepancies in patients who transit from hospital to primary care. Adult patients who made their first visit to the polyclinics following a recent hospital discharge and were prescribed with 5 or more chronic medications were randomised to 2 groups. Pre-consultation medication reconciliation by a pharmacist was carried out for the intervention group. Outcome was assessed by a different pharmacist who was blinded to the randomised allocation. The control group underwent usual care without a pre-consultation medication reconciliation.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 200
• Est. completion date: April 30, 2017
• Est. primary completion date: February 28, 2017
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 21 Years and older

Eligibility

Inclusion Criteria:

1. Age 21 years and older

2. Patient or primary caregiver was able to provide informed consent

3. Patient or primary caregiver was English, Mandarin or Malay speaking

4. Patient was able to self-administer medications, or accompanied by a caregiver who assisted in administering medications

5. Patient was prescribed 5 or more chronic medications

6. The day of the study visit was the first follow-up visit in National Healthcare Group Polyclinics for chronic disease management after recent discharge from a local public hospital

Exclusion Criteria:

1. Residents of nursing home

2. The day of the study visit was for acute illness consult

3. Unwilling to consent to a 30-day follow-up phone call.

Related Conditions & MeSH terms

• Medication Adherence
• Medication Administered in Error

Intervention

Other:
• Pre-Consultation Medication Reconciliation
Medication reconciliation service to be done for participants randomised to the intervention group

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
National Healthcare Group, Singapore

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Unintentional medication discrepancies	Any unintentional medication discrepancies after doctor's consultation	1 day
Secondary	Types of medication discrepancies	Type of medication discrepancies, by a validated instrument by Claeys et al, (Claeys C, Neve J, Tulkens PM, Spinewine A. Content Validity and Inter-Rater Reliability of an Instrument to Characterize Unintentional Medication Discrepancies.Drugs & Aging. 2012 July; 29(7): 577-91.)	1 day
Secondary	Causes of medication discrepancies	Causes of medication discrepancies, by a validated instrument by Claeys et al, (Claeys C, Neve J, Tulkens PM, Spinewine A. Content Validity and Inter-Rater Reliability of an Instrument to Characterize Unintentional Medication Discrepancies.Drugs & Aging. 2012 July; 29(7): 577-91.)	1 day
Secondary	Medication adherence	Medication adherence by The 8-item Morisky Medication Adherence Scale	30 days
Secondary	30-day re-hospitalisation	rate of re-hospitalisation 30 days after the study visit	30 days