The Effect of a Medication Coordinator on the Quality of Patients Medication Treatment

Not Applicable

• Conditions: Polypharmacy; Potentially Inappropriate Medication; Medication Therapy Management; Quality of Life; Medication Review
• Interventions: Behavioral: Medication Coordinator

• Registration Number: NCT06383364
• Lead Sponsor: University of Southern Denmark

Brief Summary

To examine the effect of a Medication Coordinator, who facilitates medication reviews in close collaboration with patients using My Medication Plan to reduce the risk of post-hospital inappropriate medication usage.

Detailed Description

Patients' safety can be compromised in the transition of care between healthcare sectors. Optimal information flow across healthcare sectors and individualized medication treatment tailored to each patient is key to prevent adverse events and optimize patient treatment. Particularly, the inclusion of the general practitioner is important in this process; it could become a challenge to keep medication changes if this communication link is missing. The framework for complex intervention allows flexibility and adaption in meeting patients' needs by implementing tailored, possibly complex interventions in different healthcare settings. To examine the effect of a Medication Coordinator, who facilitates medication reviews in close collaboration with patients using My Medication Plan. The primary outcome is the proportion of potentially inappropriate medications. Secondary outcomes include patient-reported outcomes i.e., quality of life and medication burden. Additional outcomes include the patient's individual Medication Risk Score, if the patients are readmitted, and if the patients have contacted the staff at the hospital unit after the hospital discharge.

Study Timeline

• Study First Submitted: 2024-03-18
• Study First Submitted QC: 2024-04-20
• Study First Posted: 2024-04-25
• Study Start: 2024-06-01
• Status Verified: 2024-10
• Last Update Submitted: 2024-10-28
• Last Update Posted: 2024-10-29
• Primary Completion: 2025-06-01
• Study Completion: 2025-06-01

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 140

Inclusion Criteria

• all hospitalized patients, who are prescribed at least five medications specified in the Electronic Patient Journal (EPJ) used at ward

Exclusion Criteria

• unable to communicate in Danish, cognitively impaired e.g. suffering from dementia or Alzheimer's, or cannot cooperate due to e.g. hallucination or aggressive behavior

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Interventions group	Medication Coordinator	The Medication Coordinator facilitates the medication reviews in close collaboration with the patients by applying concepts of motivational interview in combination with My Medication Plan

Primary Outcome Measures

Name	Time	Method
Change in potentially inappropriate medication according to Potentially Inappropriate Medication List	Baseline and 6 months	Evaluating the patients drug treatment to assess if a drug is a potentially inappropriate medication

Secondary Outcome Measures

Name	Time	Method
Evaluation of patients experiences quality of life with the EQ-5D and EQ-VAS.	Baseline and 3 months	EQ-5D contains five questions regarding five domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression each with five answer categories: no problems, slight problems, moderate problems, severe problems, and extreme problems. Permission for using the Danish EQ-5D version have been granted by EuroQol.; The EQ-VAS is a vertical VAS with the patient reporting their perceived quality of life from 0-100 (60). The endpoints are labelled with "The worst health you can imagine" (0) and "The best health you can imagine" (100). This VAS is used to quantify the measure of health that reflects the patient's own perception.
Evaluation of patients experienced treatment burden with the questionnaire Multimorbidity treatment burden questionnaire (MTBQ).	Baseline and 3 months	The MTBQ is a validated tool to assess patients perceived treatment burden. Treatment burden is described as patients perception of the effort required to look after their health and the effect of this on their everyday life. A Danish version of the MTBQ has been validated and is applied upon permission.; The MTBQ is a ten-item questionnaire with good content validity, high internal reliability, and good construct validity. The questions covers aspects of medication management self-monitoring, contact with healthcare professionals, obtaining information, implementing life-style changes, and relying on help. The answers are a five point Likert scale with the possibilities: "Not difficult" (0), "A little difficult" (1), "Quite difficult" (2), "Very difficult" (3), "Extremely difficult" (4), and "Does not apply" (0). The MTBQ scores are categorized into no burden (score 0), low burden (score \< 10), medium burden (score 10-22), and high burden (score ≥ 22).
Patient readmission 30 days after hospital discharge	30 days after the patient has been discharged from the hospital.	Patient readmissions are evaluated 30 days after hospital discharge. As a "did" or "did not" and a time-to-event, with a restriction of 30 days. The readmissions are assessed through the electronic patient journal.
Evaluation of patients experienced quality of life with visual analogue scale (VAS).	Baseline and 3 months	The patients are to score their experienced VAS regarding quality of life with VAS.; The VAS is a vertical VAS and ranges from zero (low quality of life) to 100 (the highest quality of life) by numbers. The endpoints are label with "The worst quality of life you can image" (0) and "The highest quality of life you can image" (100).
Evaluation of patients experienced medication burden with visual analogue scale (VAS).	Baseline and 3 months	An additional VAS regarding treatment burden is added. The VAS is a vertical VAS and ranges from zero (no burden at all) to 100 (the highest burden imagined) by numbers. The endpoints are labelled with "The worst burden you can imagine" (0) and "The highest burden you can imagine" (100).
Patient contact to the ward 30 days after hospital discharge	30 days after the patient has been discharged from the hospital.	Patient contact to the ward are evaluated 30 days after hospital discharge. As a "did" or "did not" and a time-to-event, with the restriction of 30 days. And if possible to assess which question the patient had to the ward, if it was drug-related or more disease specific. The readmission are assessed through the electronic patient journal.

Trial Locations

Locations (1)

Sygehus Sønderjylland; 🇩🇰 Aabenraa, Southern Denmark, Denmark