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Effects of Pharmacist-led Medication Reconciliation Services on Geriatric Patients

Not Applicable
Completed
Conditions
Geriatric Patients
Medication Reconcilitation Upon Hospital Admission
Medication Reconciliation At Discharge
Pharmacist-led Medication Reconciliation
Interventions
Other: Pharmacist-led medication reconciliation services
Registration Number
NCT06610292
Lead Sponsor
University of Jordan
Brief Summary

This study aims to assess the effects of Pharmacist-led medication reconciliation on hospitalized elderly patients aged above 65 at a leading tertiary military hospital in Jordan.

Detailed Description

A four-month randomized controlled trial was conducted at King Hussein Medical Hospital (KHMH), one of the Royal Military Medical Services (RMS) tertiary hospitals located in central Amman. During the study period, 128 patients were selected using convenience sampling. Later, medication histories were compared between pre-admission and admission records to obtain the Best Possible Medication History (BPMH) and identify medication discrepancies, which were categorized as either intentional (documentation errors) or unintentional discrepancies.

The already selected patients were randomly allocated into two groups (intervention and control groups). Then, Pharmacist-led medication reconciliation services were provided to the intervention group and standard care was provided to the control group. Also at discharge the number of medication discrepancies was documented. Linear regression analysis was performed to assess risk factors associated with the occurrence of unintentional discrepancies.

Within 30 days post-discharge, patients were assessed for any hospital re-admissions, emergency department visits and medication-related side effects.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
128
Inclusion Criteria
  • Newly admitted patient within no more than 24 hours and anticipated to stay in the hospital for more than 48 hours.
  • Geriatrics patients defined as those aged (≥65 years) (Orimo et al., 2006).
  • Prescribed at least one chronic medication prior to the study admission.
Exclusion Criteria
  • Patient admitted to the critical care or isolation units or in unconscious or comatose states.
  • Patients if they were discharged against medical advice.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention groupPharmacist-led medication reconciliation servicesPatients received Pharmacist-led medication reconciliation services
Primary Outcome Measures
NameTimeMethod
Describing prevalence and nature of medication discrepancies in elderly patients and investigating contributing factors to medication discrepancies.Up to 20 weeks

Linear regression analysis was performed to assess risk factors associated with the occurrence of medication discrepancies in elderly patients.

Analysis of the effects of Pharmacist-led medication reconciliation services on resolving medication discrepancies upon dischargeUp to 16 weeks

Number of resolved medication discrepancies was documented upon discharge after providing pharmacist-led medication reconciliation services.

Evaluating the impacts of Pharmacist-led medication reconciliation services on hospital re-admissions within 30 days of dischargeUp to 20 weeks

Elderly patients were assessed for number of hospital re-admissions within 30 days of discharge at control and intervention groups.

Evaluating the impacts of Pharmacist-led medication reconciliation services on emergency department visits within 30 days of dischargeUp to 20 weeks

Elderly patients were assessed for number of emergency department visits within 30 days of discharge at control and intervention groups.

Evaluating the impacts of Pharmacist-led medication reconciliation services on medications side effects within 30 days of dischargeUp to 20 weeks

Elderly patients were assessed for incidence of medications side effects within 30 days of discharge at control and intervention groups.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

University of Jordan

🇯🇴

Amman, Jordan

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