Polymedication Check - Evaluation of the Impact of Community Pharmacy Based Medication Review on Medicines Use and Humanistic Outcomes
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 450
- 试验地点
- 2
- 主要终点
- Medication possession ratio (MPR), gaps and persistence in medicines use
研究概览
简要总结
Since October 2010, Swiss community pharmacies can offer a 'Polymedication Check' (PMC) to patients on ≥4 prescribed drugs taken over ≥3 months.
Aims:
To evaluate first experiences shortly after implementation, missed pharmaceutical care issues and barriers to implementation on pharmacist's level as well as patient's acceptance through qualitative and descriptive studies To evaluate the impact of PMC in Swiss primary Care and to evaluate economic, clinical and humanistic outcomes in a subsequent randomized controlled trial.
详细描述
Evaluating the newly implemented Swiss 'Polymedication-Check', a specialised medication review and screening for adherence issues, offers a large field of interesting research questions. Using the current PMC-Protocol as a structured interview guide, pharmacists are able to document their counselling on medication use issues and other drug related problems.
In a randomized-controlled trial we aim at analysing 800 recruited patients from 70 study pharmacies during seven months. Patients were recruited in the regions Basel, Aargau-Solothurn, Waadt in Switzerland and randomised using 1:1 block randomisation.
Primary outcome focuses on the improvement of adherence and persistence after 'Polymedication Check' (using medication possession ratio (MPR), gaps in medicines history records and patient's interviews).
Second outcomes are time to planned or unplanned consulting with a physician or hospitalisation, knowledge, safety of medicines use and patients management of polypharmacy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Investigator)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •more than 3 drugs over at least 3 months prior to recruitment
- •german or french language (written and spoken)
- •medicines use in self management
排除标准
- •provision of Polymedication Check in the past
- •living in a nursing home
- •use of prefilled pill organiser or individually blistered medication
研究组 & 干预措施
Control group
Patients get no intervention at study start, but only at study end after seven months.
Intervention group
At the beginning and at the end of the study, this group receives a pharmacist's led medication review focusing on daily medicines use (= Polymedication Check).
干预措施: Medication review (Behavioral)
Observational arm
If participants after recruitment violate inclusion criteria (e.g. change from autonomous medication management to external home care) or insists on intervention despite being randomised to control group or patient condition forces pharmacist to provide a PMC.
干预措施: Medication review (Behavioral)
结局指标
主要结局
Medication possession ratio (MPR), gaps and persistence in medicines use
时间窗: Seven months after recruitment
Improvement of adherence seven months after 'Polymedication-Check' using medication possession ratio (MPR), gaps and persistence out of history records from community pharmacy.
次要结局
- Patient knowledge about his medicines(After two weeks, four and seven months after recruitment)
- Time to planned or unplanned consulting with a physician or hospitalisation(Seven months after recruitment)
- Self reported adherence(At study start and two weeks, four and seven months after after recruitment)
- Patients safety(After two weeks, four and seven months after recruitment)
研究者
Kurt Hersberger
Professor
University Hospital, Basel, Switzerland