A Pilot Prospective, Randomized Controlled Trial Assessing the Impact of Clinical Decision Support Using Comprehensive Medication Monitoring on Heart Failure Patient Outcomes
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Heart Failure，Congestive
- Sponsor
- Precera Bioscience, Inc.
- Locations
- 1
- Primary Endpoint
- Change in adherence to prescribed cardiology medications
- Status
- Withdrawn
- Last Updated
- 7 years ago
Overview
Brief Summary
The purpose of this study is to evaluate the clinical utility of comprehensive medication monitoring using the Patient Medication Profile to improve heart failure patient medication therapy and associated outcomes relative to usual care in a hospital setting.
Detailed Description
Congestive heart failure has an exceptionally high rate of hospital admission and is responsible for more re-admissions (23.5% at 30 days) in the United States than the 2nd and 3rd leading causes combined. Inadequate medication reconciliation both on admission and discharge from the hospital is a significant cause of medical error. In one study of cardiovascular patients, 44% believed they were taking a medication they were not, and 96% were unable to recall at least one medication they were taking. In the same study patients omitted on average 6.8 medications from their medication list. Medication optimization through improved adherence and reconciled medical records has been postulated to significantly improve admission and 30-day hospital readmission rates. Sano has developed a blood-based comprehensive medication monitoring tool that identifies and quantitates 235 prescription drugs and drug metabolites. It does not detect illicit drugs. This tool, which produces an output report designated the 'Patient Medication Profile', is designed to be used with clinical decision support to improve medication adherence, reduce medication errors, and optimize medication therapy. For heart failure patients, the investigators hypothesize that deploying the Patient Medication Profile with clinical decision support at key points of treatment intervention will A) improve medication adherence, B) identify and reconcile significant discrepancies in the medication list, C) result in reduced hospital admissions, and D) result in better overall patient outcomes. These outcome expectations are relative to usual care for heart failure patients.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients must have a regularly scheduled visit to a University of Pittsburgh Medical Center (UPMC) cardiology clinic in Oakland
- •Patients must have Heart Failure with Reduced Ejection Fraction (≤40%)
- •Patients have admitted to UPMC hospital facility between one and five times in past 12 months
- •Patients must be able to provide informed consent for present study
- •Patient age \> 18 years
Exclusion Criteria
- •Enrolled in Hospice
- •Patient on home inotrope (Dobutamine or milrinone)
- •World Health Organization (WHO) Group 1 or Group 5 pulmonary hypertension
- •Patient with current ventricular assist device (VAD)
- •Not able to communicate in English
Outcomes
Primary Outcomes
Change in adherence to prescribed cardiology medications
Time Frame: 30 days
For each patient, the proportion of prescribed medications that are detected using the baseline and final PMP will be calculated; change in adherence will be defined as proportion using final PMP, minus proportion using baseline PMP. Compare adherence difference in intervention vs. control groups.
Secondary Outcomes
- Baseline adherence to prescribed cardiology medications as a predictor of hospital admission for heart failure within 90 days(90 days)
- Number of hospital admissions per patient within 90 days of enrollment in intervention vs. control group(90 days)
- Drug Related Problem identification and resolution(30 days)