Optimizing Medication Therapy for Patients Recently Discharged From Hospital

Not Applicable

Terminated

• Conditions: Chronic Disease
• Interventions: Other: Pharmacist Consultation

• Registration Number: NCT02888782
• Lead Sponsor: Memorial University of Newfoundland

Brief Summary

Patients who are discharged from hospital can be overwhelmed when they suddenly have to manage new conditions or medications. These changes can be particularly difficult for people on many medications or with multiple health conditions. There is a real risk that this will lead to emergency room visits, hospital readmission, and even death. In addition to endangering patients, these adverse events are very costly to the healthcare system. The good news is that these events can be preventable if patients receive care that is better coordinated.

Patient-oriented research will be conducted to determine if a pharmacist-led medication therapy management service can improve health outcomes of 'medically complex' patients transitioning from acute to primary care in Newfoundland and Labrador (NL). This a more comprehensive service than their community pharmacist would normally provide. The program will use a new Pharmacist Clinic service to provide care and support which does not currently exist for patients in NL after they leave hospital. After discharge, patients will be randomly divided into two groups: one group will receive care as usual from their doctor; the other group will have their medications assessed by a clinic pharmacist within one week of hospital discharge along with their usual care from their doctor. The two groups will be compared to determine whether specialized pharmacist services after hospital discharge is satisfactory to patients/providers, improves patient health, and reduces emergency room visits, hospital readmissions, and repeat trips to the doctor. If successful, this project will help ensure that patients are taking the right medications in the right way, improving individual health and making better use of healthcare system resources.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2016-08-25
• Study First Submitted QC: 2016-08-30
• Study First Posted: 2016-09-05
• Study Start: 2016-12-08
• Primary Completion: 2018-04-30
• Study Completion: 2018-06-29
• Status Verified: 2018-10
• Last Update Submitted: 2018-10-04
• Last Update Posted: 2018-10-09

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 89

Inclusion Criteria

1. 50 years of age or older
2. Admitted to a General Medicine ward
3. Take 5 or more chronic medications

Exclusion Criteria

1. Discharge to a long term care facility
2. Life expectancy less than 3 months
3. Have entered palliative care
4. Cognitive impairment (unless a responsible caregiver can provide consent and assist in participation)
5. Non-English speaking
6. Unable to provide informed consent

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Pharmacist Consultation	Pharmacist Consultation	Meet with pharmacist for consultation in addition to regular physician follow up

Primary Outcome Measures

Name	Time	Method
Composite Hospital Utilization Rate	30 days post discharge	A composite score of hospital readmission rate and ER visits

Secondary Outcome Measures

Name	Time	Method
Rehospitalization Rate	90 days post discharge
Number of Emergency Room Visits	90 days post discharge
Mortality Rate	90 days post discharge
Frequency of Family Physician Visits	90 days post discharge

Trial Locations

Locations (2)

Health Sciences Center; 🇨🇦 Saint John's, Newfoundland and Labrador, Canada

St. Clares Mercy Hospital; 🇨🇦 St. John's, Newfoundland and Labrador, Canada