Patient Compliance Clinical Trial
— HomeCoMeOfficial title:
The Effect of a Home-based Community Pharmacist-led Medication Management Program (HomeCoMe-program) Complementary to an In-hospital Medication Reconciliation Program on Drug-related Problems Post-discharge: A Prospective Cohort Study.
the purpose of this study is to determine the the effect of a home-based medication management program on drug-related problems post-discharge.
Status | Completed |
Enrollment | 150 |
Est. completion date | February 2016 |
Est. primary completion date | February 2016 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - patient uses more than three prescribed systemic drugs intended for chronic use at admission and discharge - patient has an expected length of stay of 48 hours or longer Exclusion Criteria: - Patients admitted for scheduled chemotherapy - Patients admitted for radiation therapy - Patients admitted for transplantation - Patients transferred from another hospital - Patients transferred from another non-eligible ward within the same hospital - No informed consent signed - A live expectancy less than 6 months - Inability to be counselled (e.g. cognitive dysfunction, language constraints who cannot be solved with an interpreter) - Discharge to a nursing home (presuming dependence on medication administration) - If patients' community pharmacy is not participating in this study |
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care
Country | Name | City | State |
---|---|---|---|
Netherlands | Zorgapotheken Flevoland | Almere | Flevoland |
Lead Sponsor | Collaborator |
---|---|
H.T. Ensing, PharmD, MSc | Flevoziekenhuis, Almere, Zorggroep Almere |
Netherlands,
Al-Rashed SA, Wright DJ, Roebuck N, Sunter W, Chrystyn H. The value of inpatient pharmaceutical counselling to elderly patients prior to discharge. Br J Clin Pharmacol. 2002 Dec;54(6):657-64. — View Citation
Kwint HF, Faber A, Gussekloo J, Bouvy ML. The contribution of patient interviews to the identification of drug-related problems in home medication review. J Clin Pharm Ther. 2012 Dec;37(6):674-80. doi: 10.1111/j.1365-2710.2012.01370.x. Epub 2012 Aug 3. — View Citation
Schnipper JL, Kirwin JL, Cotugno MC, Wahlstrom SA, Brown BA, Tarvin E, Kachalia A, Horng M, Roy CL, McKean SC, Bates DW. Role of pharmacist counseling in preventing adverse drug events after hospitalization. Arch Intern Med. 2006 Mar 13;166(5):565-71. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Identifying and solving adverse drug events (ADEs) and other drug-related problems (DRPs) post-discharge | The total number of assessed and solved ADEs post-discharge will be measured. Assessing and solving ADEs takes place during the pharmacist home visit. Using START-STOPP criteria on patients medication records, ADEs will also be compared between the intervention and usual care group. |
within 7 days post-discharge | No |
Secondary | Improvement of adherence to medication at hospital discharge | The "medication possession ratio" will be calculated retrospectively from pharmacy dispensing data after 6 months to investigate patient's adherence and compared between the intervention and control group. | up to 6 months after discharge | No |
Secondary | Patient assessment of medication knowledge at time of home visit | At time of the home visit patients are asked about their knowledge (e.g. indication, dose regime, etc) regarding the medication they are taking. Knowledge is scored and lack of knowledge is solved by teaching the patient. | within 7 days after discharge | No |
Secondary | Types of interventions made at the pharmacist home visit | The types of intervention the pharmacist works on during the 7 day follow-up home visit are assessed. | within 7 days after discharge | No |
Secondary | Patient satisfaction with the pharmacist home visit | The satisfaction survey consists of 13 interview questions, where the subject subjectively scores each question on a four-point scale, developed specifically for this study. | Immediately after receiving the home visit | No |
Secondary | Assessment of patient reported health rating | Patient are asked by telephone to report their health on a scale from 1 (worst imaginable health) to 10 (best imaginable health). Number are compared between the intervention and control group. | at 14 days after discharge | No |
Secondary | General practitioners satisfaction with the pharmacist home visit | The satisfaction survey consists of 13 interview questions, where the subject subjectively scores each question on a four-point scale, developed specifically for this study. | Immediately after the home visit is executed | No |
Secondary | Assessment of patient reported health rating | Patient are asked by telephone to report their health on a scale from 1 (worst imaginable health) to 10 (best imaginable health). Number are compared between the intervention and control group. | at 42 days after discharge | No |
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