Impact of a Clinical Pharmacist-Led Bundled Care Model on Preventable Polypharmacy and Cost Avoidance Among Hospitalized Adults in Oman: A Prospective Randomized Controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 260
- 主要终点
- Total Healthcare Cost Avoidance per Participant
研究概览
简要总结
This study aims to evaluate whether a clinical pharmacist-led bundled care model can improve medication use and health outcomes in hospitalized adult patients with preventable polypharmacy. Preventable polypharmacy refers to the use of multiple medications when some may no longer be necessary, may be inappropriate, or may increase the risk of medication-related harm.
Participants will be randomly assigned to receive either the pharmacist-led bundled care intervention in addition to usual hospital care or usual hospital care alone. The intervention includes comprehensive medication reconciliation, assessment of medication appropriateness, identification of potentially inappropriate medications, individualized deprescribing recommendations when appropriate, patient and caregiver education, discharge medication reconciliation, and follow-up after hospital discharge.
The study will compare important clinical outcomes between the two groups, including hospital readmissions, emergency department visits, adverse drug events, medication appropriateness, quality of prescribing, and healthcare costs. The findings will help determine whether integrating a clinical pharmacist-led bundled care model into routine hospital practice can improve patient safety, optimize medication use, and reduce unnecessary healthcare utilization.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults aged 18 years or older.
- •Admitted under an adult medical specialty at one of the participating hospitals.
- •Receiving five or more regular medications at the time of hospital admission.
- •Expected hospital stay of at least 48 hours.
- •Able and willing to provide written informed consent.
排除标准
- •Admission under obstetric, pediatric, or psychiatric services.
- •Admission to an intensive care unit.
- •Terminal illness with an expected survival of less than three months.
- •Unable to provide informed consent and without an available legal representative.
- •Declines participation in the study.
结局指标
主要结局
Total Healthcare Cost Avoidance per Participant
时间窗: 90 days after hospital discharge
The difference between the intervention and control groups in total healthcare cost avoidance per participant associated with the clinical pharmacist-led bundled care model. Total cost avoidance will include direct medication and investigation cost reductions and indirect costs avoided through prevention of adverse drug events, reduced hospital length of stay, and reductions in unplanned hospital readmissions and emergency department visits. Cost avoidance will be calculated using institutional healthcare utilization and costing data and standardized cost-avoidance values for accepted pharmacist interventions.
Prevalence of Preventable Polypharmacy at Hospital Discharge
时间窗: through study completion, an average of 1 week during admission
The proportion of participants with one or more unnecessary, inappropriate, duplicative, or potentially harmful medications at hospital discharge, compared between the pharmacist-led bundled care group and the usual-care group. Preventable polypharmacy will be assessed using predefined clinical criteria, comprehensive medication review, and validated medication-appropriateness tools.
次要结局
- Number of Medications Deprescribed per Participant(through study completion, an average of 1 week during admission)
- Incidence of Adverse Drug Events(From hospital admission through 90 days after discharge)
- All-Cause Hospital Readmission(30 days and 90 days after hospital discharge)
研究者
Dr. Juhaina Al Maqbali
Senior Specialist Pharmacist
Sultan Qaboos University