Involving Clinical Pharmacists in Transitional Care to Reduce Drug-related Readmissions Among the Elderly - a Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 700
- 试验地点
- 2
- 主要终点
- Time from discharge to first drug-related readmission
研究概览
简要总结
This randomized controlled trial primarily investigates if a clinical pharmacist intervention can reduce drug-related readmissions among patients >75 years. The intervention targets the transfer between hospital and primary care. In brief, the intervention includes medical chart reviews and patient interviews during a period of 180 days.
详细描述
At discharge from the hospital, patients that meet the inclusion criteria are offered to participate in the study. At this point the investigators will also gather baseline data through questionnaires on self-reported adherence (MARS-5) and quality of life (EQ-5D). The participants are randomized to the different study arms according to a stratified procedure based on their cognitive function.
The intervention group will have their charts reviewed every second week and be contacted by the clinical pharmacist through phone within 7 and after 30 and 60 days respectively to discuss their medications. If possible drug-related problems are suspected during the interviews that cannot be solved immediately, the physician is contacted.
Both groups have a follow-up time of 30 and 180 days. After 30 and 180 days, the patients will once again report adherence and quality of life. All other data can be gathered from the medical charts.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Outcomes Assessor)
盲法说明
A group of physicians and clinical pharmacists will asses whether readmissions are drug-related or not. This group is blinded.
入排标准
- 年龄范围
- 75 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Living at home
- •Acutely admitted
- •Registered at one of ten pre-specified primary care health centers
排除标准
- •Patients unable to communicate or who do not speak Swedish
- •Patients scheduled for palliative care
- •Patients admitted due to intoxication by alcohol or drug (non prescription)
结局指标
主要结局
Time from discharge to first drug-related readmission
时间窗: 180 days
Survival analysis with drug-related readmission as endpoint
次要结局
- Time from discharge to first drug-related readmission(30 days)
- Frequency of drug-related readmissions - subgroups with/without heart failure(30 and 180 days)
- Time from discharge to first all-cause hospital visit(30 and 180 days)
- Frequency of drug-related readmissions(30 and 180 days)
- Time from discharge to first drug-related readmission - subgroups with/without cognitive impairment(30 and 180 days)
- Frequency of drug-related readmissions - subgroups with/without cognitive impairment(30 and 180 days)
- Self-reported adherence(30 and 180 days)
- Mortality(30 and 180 days)
- Time from discharge to first drug-related readmission - subgroups with/without heart failure(30 and 180 days)
- Frequency of all-cause hospital visits(30 and 180 days)
- Self assessed quality of life: EQ-5D-questionnaire(30 and 180 days)
- Health economics(180 days)
- Medication appropriateness(180 days)
研究者
Maria Gustafsson
Principal Investigator
Umeå University