A Multidisciplinary Approach to Improve Adherence to Medical Recommendations in Older Adults
- Conditions
- FallMedication AdherenceAgingMultidisciplinary CommunicationHospital Discharge
- Interventions
- Behavioral: Educational training
- Registration Number
- NCT05719870
- Lead Sponsor
- University Hospital of Ferrara
- Brief Summary
Background and overall goal: Poor comprehension and medication adherence are common in older people, especially after hospitalizations, in case of changes or prescriptions of new therapeutic regimes. The aim of this project is to evaluate the effectiveness of a multidomain intervention with an integrated care approach, in improving medication adherence in older people after hospital discharge. A secondary aim is investigate the determinants of poor comprehension and medication adherence in such individuals.
Target population: The project will involve older patients hospitalized in a Geriatric Department and discharged at home, and (when present) their caregivers.
Methods and assessments: Upon hospital discharge, data from the comprehensive geriatric assessment and information on the present hospitalization and prescribed therapies will be collected for all participants. The comprehension of medical recommendations reported in the discharge summary will be evaluated for all patients/caregiver before and after the routine explanation by treating physicians. Participants will be then randomized in intervention vs. control group. The intervention will include: first, educational training of patients/caregivers at hospital discharge by a multidisciplinary team; second, after hospital discharge, a phone recall on the prescribed therapies and a one-week phone consultant service managed by a geriatrician, supported by the multidisciplinary team, to address potential concerns on prescribed treatments. Control group will follow usual care. After 7 days medication adherence will be assessed for both study groups through structured phone interviews. At 30 and 90 days from discharge, data on falls, rehospitalizations and vital status will be collected through hospital records.
- Detailed Description
Background and overall goal: Poor comprehension and medication adherence are common in older people, especially after hospitalizations, in case of changes or prescriptions of new therapeutic regimes. The aim of this project is to evaluate the effectiveness of a multidomain intervention with an integrated care approach, in improving medication adherence in older people after hospital discharge. Moreover, a secondary aim is to investigate the determinants of poor comprehension and medication adherence in such individuals.
Target population: The project will involve older patients hospitalized in a Geriatric Department and discharged at home, and (when present) their caregivers.
Methods and assessments: Upon hospital discharge, data from the comprehensive geriatric assessment and information on the present hospitalization and prescribed therapies will be collected for all participants. The comprehension of medical recommendations reported in the discharge summary will be evaluated for all patients/caregiver before and after the routine explanation by treating physicians. Participants will be then randomized in intervention vs. control group. The intervention will include: first, educational training of patients/caregivers at hospital discharge by a multidisciplinary team; second, after hospital discharge, a phone recall on the prescribed therapies and a one-week phone consultant service managed by a geriatrician, supported by the multidisciplinary team, to address potential concerns on prescribed treatments. Control group will follow usual care. After 7, 30 and 90 days, data on medication adherence, falls, rehospitalizations and vital status will be assessed for both study groups through structured phone interviews and hospital records.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 360
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention group Educational training Patients hospitalized in the Geriatric Unit aged 60 years or older, that living in the community setting and who will be discharged at home and with expected survival \>7 days.
- Primary Outcome Measures
Name Time Method Comprehension of medical recommendation at hospital discharge At baseline (corresponding to hospital discharge) number of mistakes in recalling the prescribed therapy
Adherence to the recommendations provided by the occupational therapist at hospital discharge 7 days after hospital discharge number of days per week of recommendations' adherence
Adherence to medical recommendations given at hospital discharge 7 days after hospital discharge number of discrepancies in taking the prescribed therapy
- Secondary Outcome Measures
Name Time Method Number of rehospitalizations 30 and 90 days after hospital discharge Evaluation through structured telephone interviews
Number of emergency department visits 30 and 90 days after hospital discharge Evaluation through structured telephone interviews
Mortality 7, 30 and 90 days after hospital discharge Assessment of vital status through hospital records and telephone interviews
Number of falls 30 and 90 days after hospital discharge Evaluation through structured telephone interviews
Trial Locations
- Locations (2)
Geriatric Unit of Ferrara Hospital
🇮🇹Ferrara, Italy
Geriatric Unit of the Padua Central Hospital
🇮🇹Padova, Italy