Medication Intervention in Transitional Care to Optimize Outcomes & Costs for CKD & ESRD

Not Applicable

Completed

• Conditions: Chronic Kidney Disease; End-Stage Renal Disease
• Interventions: Other: Usual care for hospital discharge; Other: Medication Information Transfer Intervention

• Registration Number: NCT01459770
• Lead Sponsor: Providence Medical Research Center

Brief Summary

Transitional care strategies focused on enhancing the accuracy and comprehensiveness of medication information transfer will lead to improved health outcomes among hospitalized patients with chronic kidney disease.

Detailed Description

Patients with CKD and ESRD have more co-morbidities, are hospitalized more often and for longer lengths of stay, and incur greater healthcare costs than patients with other chronic conditions. Enhanced hospital to home transitional care interventions have been shown to improve medication information transfer, reduce hospital readmissions, and slow the progression of declining health in the general population of hospitalized patients. What is not known is the impact enhanced transitional care can have for a very high-risk population, such as those with CKD and ESRD. Interventions that prevent or slow CKD progression, i.e. blood pressure control and intensive glycemic control in patients with diabetes, are all highly dependent on meticulous medication management.

For hospitalized patients with CKD or ESRD who are transitioning to home, accurate and comprehensive information transfer is essential to optimal medication management. CKD and ESRD patients are in critical need of improved transitional care that includes accurate and comprehensive medication information transfer. The main objective of this application is to pilot-test the effectiveness of a medication information transfer intervention to improve clinically-relevant outcomes. To this end, the following Specific Aims will be achieved: 1. Evaluate the impact of transitional care interventions on acute care utilization following hospital discharge among patients with CKD or ESRD. 2. Evaluate the impact of transitional care strategies on management of CKD or ESRD management and complications.

Study Timeline

• Study First Submitted: 2011-10-24
• Study First Submitted QC: 2011-10-24
• Study First Posted: 2011-10-26
• Study Start: 2011-11
• Primary Completion: 2015-12
• Study Completion: 2016-04
• Status Verified: 2017-04
• Last Update Submitted: 2017-04-04
• Last Update Posted: 2017-04-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

Not provided

Exclusion Criteria

1. Kidney Transplant

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
control	Usual care for hospital discharge	usual care for hospital discharge: 1. CKD group 2. ESRD group
intervention	Medication Information Transfer Intervention	pharmacist administered medication information transfer intervention 1. CKD group 2. ESRD group

Primary Outcome Measures

Name	Time	Method
acute care utilization	90 days	Acute care utilization defined by emergency department visits and hospitalizations in the first 30 and 90 days after discharge from the index hospitalization.

Secondary Outcome Measures

Name	Time	Method
CKD status, risk factors and complications	30 and 90 days	blood pressure, eGFR, urine albumin/creatinine ratio, fasting glucose, HbA1c (in the diabetic subgroup), lipids, hemoglobin, phosphorus, PTH, serum potassium.
ESRD status, risk factors and complications:	30 and 90 days	blood pressure, fasting glucose,HbA1c (in the diabetic subgroup), lipids, hemoglobin, phosphorus, PTH, serum potassium

Trial Locations

Locations (1)

Providence Sacred Heart Medical Center & Children's Hospital; 🇺🇸 Spokane, Washington, United States