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LEAVE Safe With DOACs

Not Applicable
Completed
Conditions
Atrial Fibrillation
Bleeding
Cardiovascular Diseases
Venous Thromboembolism
Stroke
Interventions
Other: Clinical Pharmacist Intervention
Registration Number
NCT04068727
Lead Sponsor
University of Massachusetts, Worcester
Brief Summary

Given the risks associated with direct oral anticoagulants (DOACs) and the lack of defined pathways for patients prescribed this class of medications, the study intervention has the potential for an enormous impact in preventing medication errors and improving the quality of care transition, patient knowledge, and adherence with DOAC therapy.

Detailed Description

Patients first treated with direct oral anticoagulants (DOACs) in an ambulatory setting are at an elevated risk for adverse drug events (ADEs) or potential ADEs from medication errors. An intervention that integrates clinical pharmacists, a pharmacy technician, and follows a checklist published by experts at the Anticoagulation Forum can prevent adverse outcomes. The Investigators propose research on the effectiveness, implementation, and dissemination for a care transition intervention that follows the checklist which includes evaluation for appropriateness of DOAC use, assistance with drug procurement, telephone access to an anticoagulation expert, and other best practice recommendations.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
561
Inclusion Criteria
  • Age ≥ 18
  • New prescription of DOAC within 4 days of consent OR continued DOAC use for a patient with new episode of worsening thromboembolic or bleeding event within 4 days of consent or discharged from the hospital with DOAC prescription within 4 days of consent
  • Fluency in English, Portuguese, or Spanish
Exclusion Criteria
  • Currently hospitalized with inpatient status (as opposed to observation status)
  • Age < 18
  • Prisoners
  • Pregnant patients (medications are contraindicated)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Clinical Pharmacist InterventionClinical Pharmacist Intervention-
Primary Outcome Measures
NameTimeMethod
Number of Direct Oral Anticoagulant (DOAC)-Related Clinically Important Medication Errors90 Days Post Enrollment

The number of preventable, ameliorable and potential Adverse Drug Events (ADEs) that physician reviewers attribute to Direct Oral Anticoagulant (DOAC) medication. Each DOAC related clinically important medication error is counted as a separate event, enabling patients to have multiple events consistent with the literature.

Secondary Outcome Measures
NameTimeMethod
Patient Knowledge regarding Anticoagulation and Venus Thromboembolism (VTE) using the Anticoagulation and Venus Thromboembolism (VTE) knowledge questionnaire90 Days Post Enrollment

Patient knowledge regarding Anticoagulation and Venus Thromboembolism (VTE) will be evaluated using a modified version of a 22-item instrument previously developed and tested by the institution. This instrument assesses patients' knowledge of warning signs of bleeding and new VTE, interactions with other medications, and complications of VTE. A low score indicate a low level of knowledge and a high score indicates a high level of knowledge regarding anticoagulation and VTE.

Medication Possession Ratio (MPR) to assess medication adherence90 Days Post Enrollment

Medication adherence is measured with Medication Possession Ratio (MPR) which is the ratio between the time a patient had medication on hand, the time that a patient is eligible to have a medication on hand, and the time that a patient is covered by the medication. The MPR ratio will be calculated by using available pharmacy data.

Number of missed or extra doses to assess medication adherence90 Days Post Enrollment

Patients are asked to to count out the number of remaining pills from the last filled prescription and provide the fill date, number of pills dispensed, the schedule prescribed (either once or twice a day depending on DOAC), and skipped doses for deliberate interruption to determine medication adherence with the number of missed or extra doses.

Proportion of days covered (PDC) to assess medication adherence90 Days Post Enrollment

Proportion of Days Covered (PDC) is the ratio between the time that a patient has a medication on hand, the time that a patient is eligible to have a medication on hand, and the time that a patient is covered by the medication. Medication adherence will be evaluated using the mean PDC using available pharmacy data.

Trial Locations

Locations (1)

UMass Memorial Medical Center

🇺🇸

Worcester, Massachusetts, United States

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