A Systems aPproach to community-based medIcation REview for people at risk of medication harm after a hospital stay: ASPIRE trial

Not Applicable

• Conditions: polypharmacy; medication error; inappropriate prescribing; multimorbidity; medication non-adherence; preventable hospitalisations; Public Health - Health service research

• Registration Number: ACTRN12623000121662
• Lead Sponsor: The University of Sydney

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2023-02-06
• Last Update Posted: 13 February 2023

Recruitment & Eligibility

• Status: ot yet recruiting
• Sex: All
• Target Recruitment: 2112

Inclusion Criteria

Adult hospital in-patients who
1.Reside in the Primary Health Network of the hospital site.
2.Have a Medicare card
3Have a nominated GP or nominated general practice in the Primary Health Network
4.Have a nominated community pharmacy in the Primary Health Network
5.Meet one or more of the following:
i.) Admission is due to a medication-related problem (as recorded in patient’s notes or identified during ward round)
ii.) Is taking 10 or more medicines (including PRN)
iii.) Has been started on 1 or more high-risk medicines during admission
iv.) Has had 4 or more changes made to medicines during admission
v.) Has had 1 or more change to a high-risk medicine or to a falls risk increasing medicine during admission
vi.) Is taking 2 or more falls risk increasing, anticholinergic or sedative medicines on discharge
vii.) Has difficulty managing medicines, as assessed by patient, GP, medical team or pharmacist, due to 1 or more of: (a) literacy or language; (b) dexterity or vision or frailty or mobility; (c) cognitive impairment or confusion or dementia; or (d) access to medicines (e.g., financial)

Definitions
High risk medicines include but are not limited to insulins, anticoagulants, oral hypoglycaemics, dual antiplatelet therapy, digoxin, opioids, oral cytotoxics, sedatives, hypnotics, anxiolytics, antipsychotics, anticholinergic medicines

Falls-risk increasing medicines include but are not limited to medicines listed in the NSW TAG Medication-related Falls Risk Assessment Tool.

Anticholinergic medicines include but are not limited to medicines listed in 'Drugs with anticholinergic effects', Australian Medicines Handbook

Sedative medicines include but are limited to medicines listed in 'Drugs for Anxiety and sleep disorders', Australian Medicines Handbook

Exclusion Criteria

Individuals will be excluded if they
1.are younger than 45 years of age.
2.are receiving active radiation therapy or chemotherapy for malignant conditions
3.have been admitted for planned dialysis
4.are in terminal phase of palliative care
5.are unable to attend Medication Management Review within the time frame
6.have previously been recruited to ASPIRE trial
7.are being transferred to a rehabilitation, private or other hospital

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The proportion of people with at least one unplanned all-cause readmission to hospital in the intervention group compared to control /usual care.<br><br>Data linked from state hospital admitted patient care data collections will be assessed to determine the number of unplanned hospital readmissions.[90 days after discharge]