Deprescribing for Older Adults After Hospital Discharge in Home Health Care

Polypharmacy Clinical Trial

Official title:

Deprescribing for Older Adults After Hospital Discharge in Home Health Care - A Pilot Feasibility Study of the HomeMed Deprescribing Intervention

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT05630144
• Other study ID #: STUDY00007846
• Secondary ID: R24AG064025
• Status: Active, not recruiting
• Phase: N/A
• Start date: March 29, 2023
• Est. completion date: September 30, 2024

Study information

• Verified date: January 2024
• Source: University of Rochester
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to examine the feasibility of providing a medication optimization program to improve patient health outcomes during the transition from hospital to home. This is because the period after hospital discharge is critical to long-term recovery, overall quality of life, and prevention of future hospitalizations.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 5
• Est. completion date: September 30, 2024
• Est. primary completion date: September 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years and older

Eligibility

Patient Inclusion Criteria:

• 65 years of age and older

• currently hospitalized or having been hospitalized in the previous 2 weeks

• having a discharge disposition of home with a referral to receive HHC services from URMHC, or currently receiving HHC services from URMHC

• taking more than 10 regular medications daily

• having a primary care provider who is in the URMC system

• Ability to self-consent

• English-speaking

Patient Exclusion Criteria:

• end-of-life prognosis in the following 6 months

• currently receiving hospice care, end-of-life care, or palliative care

• conditions that impact the receipt of the intervention, such as severe cognitive impairment that interferes with the subject's ability to communicate with interventionists;

• substantial difficulties in hearing, vision, and verbal expression that disable the participant from communicating effectively while receiving the HomeMed intervention

Related Conditions & MeSH terms

• Polypharmacy

Intervention

Behavioral:
• HomeMed
The HomeMed intervention is a multidisciplinary deprescribing intervention including home visits and team-based telehealth communication (optional). The components included in the HomeMed intervention include home medication review, medication education and provision of tools to assist the patients with medication administration, assessment of deprescribing targets by a trained geriatric clinical pharmacist, communication with the patient's treating primary care provider about deprescribing recommendation, deprescribing implementation (optional), and deprescribing monitoring (optional). Depending on the patient's treating primary care provider's decision on deprescribing and monitoring, the number of home visits ranges from a minimum of three to more with the entire duration of the intervention ranging from approximately 1 to 3 months.

Locations

Country	Name	City	State
United States	University of Rochester Medical Center	Rochester	New York

Sponsors (2)

Lead Sponsor	Collaborator
University of Rochester	National Institute on Aging (NIA)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	mean time spent on intervention		3 months
Primary	number of participants who complete a post intervention survey about feasibility		3 months
Primary	Percentage of participants undergoing deprescribing		3 months
Primary	Percentage of intervention adherence indicators checked		3 months
Primary	Percentage of patients who improve in ability to do things that are important before and after intervention		3 months
Primary	Total number of medications used per participant		3 months
Primary	Percentage of patients who report a reduction in medication burden	Medication burden will be reported by phone or survey.	3 months
Primary	Percentage of participants who report a reduction in medication side effect	Side effects will be collected by phone.	3 months