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Evaluating the impact of a pre-discharge medication review service on preventing hospital re-admissions in high risk patients-a pilot study.

Not Applicable
Conditions
Medication misadventure
Poly-Pharmacy
Co-morbidities
Adverse drug reactions
Poor compliance
Public Health - Health service research
Registration Number
ACTRN12615000746538
Lead Sponsor
niversity of Tasmania
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot yet recruiting
Sex
All
Target Recruitment
226
Inclusion Criteria

The recruitment of eligible patients will be predicated upon the risk assessment tool as described by Angley and co-workers.

Patients were stratified as being at ‘high’
or ‘low’ risk of medication misadventure using a stratification instrument adapted from the Victorian Medication Alert Project and The Alfred Hospital Outreach Medication Review program. Patients who scored more than 5 points were at ‘high’ risk of medication misadventure. They will be invited to join the study or control cohorts.

The risk weighting per question is outlined in the attached file. Score per question ranges from 1 to 5.

Angley M, Pooniah A, Bong J., Padhye V, Shakib S, Spurling L. Implementing and evaluating a parallel post-discharge Home Medicines Review (HMR) model: Pharmacy Guild of Australia;
2011.

Exclusion Criteria

1. Patients will be excluded if they are to be discharged into an aged care facility (ACF), since each ACF has, under the Medicare provisions, a contracted consultant pharmacist who performs medication reviews within the ACF setting.

2. Patients will be excluded if they live outside of the Greater Sydney area, interstate (or further).

3. Patients will be excluded if they are unable agree to a medication review and the follow-up phone contact within the timeframe as set out for this study.

4. Patients will be excluded if there is an obvious language barrier which cannot be resolved with the aid of a family member.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
An evaluation of the rate of readmission, assessed through hospital records and phone contact with the patient/patient's carer/spouse/family. <br>[Day 7, 90 and 180 days post discharge];An evaluation of the rate of mortality assessed through hospital records and phone contact with the patient/patient's carer/spouse/family. <br>[Day 7, 90 and 180 days post discharge];An evaluation of the rate of morbidity assessed through hospital records and phone contact with the patient/patient's carer/spouse/family. [Day 7, 90 and 180 days post discharge]
Secondary Outcome Measures
NameTimeMethod
1. Litigation impact will be assess by comparing the total number of lawsuits files by study and control patients. [Lawsuits filed from the day of discharge to day 180 post discharge. ];Quality of Life - assessed by the EUROHIS-QOL 8-item index.[Day 7, 90 and 180 days post discharge];Adherence - assessed by the Morisky Eight-Item Medication Adherence Scale[Day 7, 90 and 180 days post discharge];Patient assessment of the in-hospital pre-discharge medication review program using a questionnaire devised by the research student. with the approval of my university supervisors. It will be a Likert style question.[D7-D30 post discharge]
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