Effectiveness of Pre-Consultation Medication Reconciliation Service in Reducing Unintentional Medication Discrepancies During Transition of Care From Hospital Discharge to Primary Care Setting

Not Applicable

Completed

• Conditions: Medication Administered in Error; Medication Adherence
• Interventions: Other: Pre-Consultation Medication Reconciliation

• Registration Number: NCT03181906
• Lead Sponsor: National Healthcare Group, Singapore

Brief Summary

This study evaluates the the effectiveness of pre-consultation Medication Reconciliation Service in reducing unintentional medication discrepancies among patients who discharged from hospital to primary care.

Detailed Description

Medication discrepancies during care transition were common. Many factors contribute to the risk of medication discrepancies. Despite medication reconciliation service being practiced in the hospital setting, there was limited knowledge on its effectiveness in the primary care setting. This study aims to evaluate the effectiveness of a pre-consultation medication reconciliation service in reducing medication discrepancies in patients who transit from hospital to primary care. Adult patients who made their first visit to the polyclinics following a recent hospital discharge and were prescribed with 5 or more chronic medications were randomised to 2 groups. Pre-consultation medication reconciliation by a pharmacist was carried out for the intervention group. Outcome was assessed by a different pharmacist who was blinded to the randomised allocation. The control group underwent usual care without a pre-consultation medication reconciliation.

Study Timeline

• Study Start: 2016-03-11
• Primary Completion: 2017-02-28
• Study Completion: 2017-04-30
• Status Verified: 2017-06
• Study First Submitted: 2017-06-02
• Study First Submitted QC: 2017-06-07
• Last Update Submitted: 2017-06-07
• Study First Posted: 2017-06-09
• Last Update Posted: 2017-06-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

1. Age 21 years and older
2. Patient or primary caregiver was able to provide informed consent
3. Patient or primary caregiver was English, Mandarin or Malay speaking
4. Patient was able to self-administer medications, or accompanied by a caregiver who assisted in administering medications
5. Patient was prescribed 5 or more chronic medications
6. The day of the study visit was the first follow-up visit in National Healthcare Group Polyclinics for chronic disease management after recent discharge from a local public hospital

Exclusion Criteria

1. Residents of nursing home
2. The day of the study visit was for acute illness consult
3. Unwilling to consent to a 30-day follow-up phone call.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Pre-Consultation Medication Reconciliation	Pre-Consultation Medication Reconciliation	Participants underwent medication reconciliation service before their consultation with the attending doctor. A best possible medication history (BPMH) was created and saved as an electronic draft in the electronic medical record system.

Primary Outcome Measures

Name	Time	Method
Unintentional medication discrepancies	1 day	Any unintentional medication discrepancies after doctor's consultation

Secondary Outcome Measures

Name	Time	Method
Types of medication discrepancies	1 day	Type of medication discrepancies, by a validated instrument by Claeys et al, (Claeys C, Neve J, Tulkens PM, Spinewine A. Content Validity and Inter-Rater Reliability of an Instrument to Characterize Unintentional Medication Discrepancies.Drugs \& Aging. 2012 July; 29(7): 577-91.)
Causes of medication discrepancies	1 day	Causes of medication discrepancies, by a validated instrument by Claeys et al, (Claeys C, Neve J, Tulkens PM, Spinewine A. Content Validity and Inter-Rater Reliability of an Instrument to Characterize Unintentional Medication Discrepancies.Drugs \& Aging. 2012 July; 29(7): 577-91.)
Medication adherence	30 days	Medication adherence by The 8-item Morisky Medication Adherence Scale
30-day re-hospitalisation	30 days	rate of re-hospitalisation 30 days after the study visit