Clinical Pharmacist Intervention to Reduce Drug-related Readmissions Among Older People
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Enhanced clinical pharmacist service.
- Who it may be relevant to
- Registry conditions: Drug Use. Basic parameters: from 75 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Sweden
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Involving Clinical Pharmacists in Transitional Care to Reduce Drug-related Readmissions Among the Elderly - a Randomized Controlled Trial
Overview
This randomized controlled trial primarily investigates if a clinical pharmacist intervention can reduce drug-related readmissions among patients \>75 years. The intervention targets the transfer between hospital and primary care. In brief, the intervention includes medical chart reviews and patient interviews during a period of 180 days.
Detailed description
At discharge from the hospital, patients that meet the inclusion criteria are offered to participate in the study. At this point the investigators will also gather baseline data through questionnaires on self-reported adherence (MARS-5) and quality of life (EQ-5D). The participants are randomized to the different study arms according to a stratified procedure based on their cognitive function.
The intervention group will have their charts reviewed every second week and be contacted by the clinical pharmacist through phone within 7 and after 30 and 60 days respectively to discuss their medications. If possible drug-related problems are suspected during the interviews that cannot be solved immediately, the physician is contacted.
Both groups have a follow-up time of 30 and 180 days. After 30 and 180 days, the patients will once again report adherence and quality of life. All other data can be gathered from the medical charts.
Interventions
- Other Enhanced clinical pharmacist service
The intervention includes regular medical chart reviews, multiple patient interviews and, if needed, collaboration with the primary care physician.
Primary outcome measures
- Time from discharge to first drug-related readmission [Time frame: 180 days]
Secondary outcome measures (12)
- Time from discharge to first drug-related readmission [Time frame: 30 days]
- Frequency of drug-related readmissions [Time frame: 30 and 180 days]
- Time from discharge to first drug-related readmission - subgroups with/without heart failure [Time frame: 30 and 180 days]
- Time from discharge to first drug-related readmission - subgroups with/without cognitive impairment [Time frame: 30 and 180 days]
- Frequency of drug-related readmissions - subgroups with/without cognitive impairment [Time frame: 30 and 180 days]
- Frequency of drug-related readmissions - subgroups with/without heart failure [Time frame: 30 and 180 days]
- Time from discharge to first all-cause hospital visit [Time frame: 30 and 180 days]
- Frequency of all-cause hospital visits [Time frame: 30 and 180 days]
- Self-reported adherence [Time frame: 30 and 180 days]
- Self assessed quality of life: EQ-5D-questionnaire [Time frame: 30 and 180 days]
- Health economics [Time frame: 180 days]
- Medication appropriateness [Time frame: 180 days]
Eligibility criteria
Inclusion criteria
- Living at home
- Acutely admitted
- Registered at one of ten pre-specified primary care health centers
Exclusion criteria
- Patients unable to communicate or who do not speak Swedish
- Patients scheduled for palliative care
- Patients admitted due to intoxication by alcohol or drug (non prescription)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Other
Study locations
Sweden · 1 center
- Medical Centre, University Hospital of Umeå — Umeå
Publications
- Kindstedt J, Svahn S, Sjolander M, Glader EL, Lovheim H, Gustafsson M. Investigating the effect of clinical pharmacist intervention in transitions of care on drug-related hospital readmissions among the elderly: study protocol for a randomised controlled trial. BMJ Open. 2020 Apr 27;10(4):e036650. doi: 10.1136/bmjopen-2019-036650. PMID 32345700
Identifiers
NCT: NCT03671629 · UmU-2018-700