Patient Pathway Pharmacist - Optimal Drug-related Care

Not Applicable

Completed

• Conditions: Patient Fall; Aging; Hip Fractures
• Interventions: Procedure: Patient Pathway Pharmacist intervention

• Registration Number: NCT03695081
• Lead Sponsor: Sykehuset i Vestfold HF

Brief Summary

Medication errors represent the most common cause of patient injury and one of the most frequently reported health related deviation in Norway. The addition of a dedicated clinical pharmacist throughout the hip fracture patient pathway (patient pathway pharmacist) is believed to improve patient safety and ensure optimal drug-related patient care. The pharmacist will perform medication reconciliation at admission to hospital, medication review after surgery and assist physicians with discharge summary. Six weeks after discharge the patient pathway pharmacist will perform a second drug reconciliation and medication review. This study will assess the pharmacists' place and specific tasks in the patient pathway, describe areas where the pharmacist contribute to increased quality of care and assess the benefits and/or disadvantages experienced with introducing a patient pathway pharmacist. The estimated number of patients included is 60. Current practice will be determined by investigating the last 50 patients' medical record and a questionnaire to health care professionals involved in treatment of hip fracture patients. Data from medication reconciliation and drug review will be collected and compared to current practice. After the inclusion period, focus group surveys and/or semi-structured interviews will be executed to describe the perceived improvement in the quality of care. Primary endpoints are: 1) Medication reconciliation score at admission 2) Number of inappropriate drugs for elderly 3) Discharge summary score 4) Discharge summaries following procedure. Secondary endpoints are readmissions and mortality after 30 and 90 days. Qualitative endpoints: 1) Health care professionals experience of current drug-related practice 2) Experienced advantages and disadvantages of a patient pathway pharmacist.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-09-03
• Study First Submitted: 2018-09-11
• Study First Submitted QC: 2018-10-02
• Study First Posted: 2018-10-03
• Primary Completion: 2019-06-15
• Status Verified: 2023-06
• Study Completion: 2023-06-28
• Last Update Submitted: 2023-06-28
• Last Update Posted: 2023-06-29

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Hip fracture patients in Vestfold county, Norway

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Exclusion Criteria

• Patients under 18 years
• Terminally ill
• Hip fracture patients who do not follow the standardized patient pathway at Vestfold Regional Hospital
• Patients who do not consent to be included in the study

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Patient Pathway Pharmacist intervention	Patient Pathway Pharmacist intervention	1. Medication reconciliation at admission to hospital 2. Medication review post surgery 3. Optimised list of drugs in the discharge summary, in accordance with hospital procedures 4. Medication reconciliation, six weeks after discharge 5. Medication review, six weeks after discharge

Primary Outcome Measures

Name	Time	Method
Admission summary score	At hospital admission (estimated to be within 24 hours after fracture)	In the admission summary, the section describing drugs is scored. The score is adjusted from the discharge summary score to fit the admission note.
Number of inappropriate drugs at discharge	During hospitalisation, after surgery (estimated to be within five days after fracture/inclusion)	After surgery the medication review may reduce the number of inappropriate drugs (on the STOPP-list).
Discharge summaries written in accordance with procedure	At discharge (estimated five days after fracture/inclusion)	In the discharge summary, the section describing drugs should be in accordance with procedure.
Discharge summary score	At discharge (estimated five days after fracture/inclusion)	In the discharge summary, the section describing drugs is scored in accordance with the national patient safety program

Secondary Outcome Measures

Name	Time	Method
Readmission	90 days after discharge	Patients who are readmitted to hospital is quantified
Death	90 days after discharge	The number of patients who dies is quantified

Trial Locations

Locations (1)

Vestfold Hospital Trust; 🇳🇴 Tønsberg, Norway