Medication Reconciliation Technology to Improve Quality of Transitional Care
Overview
- Phase
- Phase 3
- Intervention
- Not specified
- Conditions
- Medication Reconciliation
- Sponsor
- Indiana University
- Enrollment
- 4818
- Locations
- 1
- Primary Endpoint
- Reconciliation of outpatient medications
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
This study addresses the problem of inadequate medication reconciliation as patients cross boundaries between inpatient and outpatient care (ambulatory care). The purpose of this study is to determine whether a new, computer-based application, integrated with electronic prescribing, improves erroneous discrepancies between pre-hospital medications and medications upon patients' return to ambulatory care.
Detailed Description
This project will test a systems-based intervention of the electronic medical records system. The specific aims of this study are to integrate a new electronic medication reconciliation (MR) system with an electronic prescribing system, conduct a randomized controlled trial of MR, and determine whether electronic facilitation of MR alters MR and the incidence of medication errors in ambulatory care. On a patient's hospital admission, a new Web-based MR module will receive an automatically compiled outpatient medication list. Following discussion with the patient, medical personnel will update the list, which will then be delivered to the computer-based provider order entry system and become actionable for prescribing. Main outcomes include adverse drug events and erroneous discrepancies between the pre-admission medication list and the medication list upon the patient's return to ambulatory care. We hypothesize that electronic facilitation of inpatient MR will improve completion of MR and will decrease the incidence of drug-related medical errors.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients admitted to the Medicine Service during a 12-month period
- •Physicians who provide inpatient or ambulatory care for participating patients.
- •Pharmacists who provide care for participating patients.
Exclusion Criteria
- •Patients admitted but not seen in a primary-care clinic within the preceding 12 months
- •If an enrolled subject is determined to be a prisoner or pregnant woman, then the study will discontinue the subject for research purposes or will submit an amendment at that time.
Outcomes
Primary Outcomes
Reconciliation of outpatient medications
Time Frame: Hospital admission, transfer, and discharge; 1 year
Number and fraction of outpatient medications prescribed or addressed as to why prescribing did not occur. Number and fraction of cases with MR by a pharmacist. Number and fraction of cases undergoing any MR. Number and fraction of cases where any outpatient medications were not prescribed or addressed as to why prescribing did not occur.
Secondary Outcomes
- Reportable financial and organizational dimensions(Start of trial; time 0 and 1 year)
- Measurement of potential for harm and potential severity of harm(Hospital discharge; 1 year)
- Measurement and analysis of providers' perspectives(Start and end of trial; 1 year)
- Measurement and analysis of patients' perspectives(Hospital discharge; 1 year)
- Measurement of adverse drug events and near misses(Hospital discharge; 1 year)
- Measurement and analysis of drug-related medical errors(Hospital discharge; 1 year)
- Medication discrepancies between pre-admission and ambulatory followup(Ambulatory followup; 18 months)
- Utilization of intervention(Hospital admission, transfer, and discharge; 1 year)