Collaborative Home Visits to Reduce Hospital Readmissions and Improve Medication Use During Transitions of Care

NCT ID: NCT02087072

Last Updated: 2022-09-30

Basic Information

• Recruitment Status: WITHDRAWN
• Study Classification: OBSERVATIONAL
• Study Start Date: 2013-10-31
• Study Completion Date: 2014-12-31

Brief Summary

The primary objective is to develop a sustainable practice model emphasizing home visits by a collaborative physician and pharmacist team to decrease unplanned emergency department visits and hospital readmissions at 30 and 90 days for high-risk home bound patients. Secondary objectives include (1) tracking the number, type, and severity of adverse drug events (ADE) and potential adverse drug events (pADE) that occur following hospital discharge and (2) resolving any identified ADE and pADE within 7 days of hospital discharge.

Adult patients will be scheduled for a home visit by the Healthy at Home Columbus program at the time of hospital discharge. The home visit will occur within 7 days of hospital discharge and will consist of a complete hospital and medication review by a physician or nurse practitioner and a pharmacist (including all lab tests, imaging studies, medication changes, and proposed plan of care at the time of discharge). The investigators hypothesize these home visits will reduce 30 and 90 days hospital readmission rates and ED visits.

The number of emergency department visits and unplanned hospital readmissions will be tracked at 30 and 90 days following discharge from the hospitalization that led to study enrollment. A comparison cohort of patients discharged in the 12 months prior to study initiation will be used to compare the effectiveness of the home visit program. The number and type of adverse drug events (ADE) and potential adverse drug events (pADE) that occur during transitions of care will also be characterized. All ADE and pADE will be resolved during the initial home visit and will be classified based on severity. All ADE and pADE will be evaluated independently by two pharmacist reviewers; each reviewer will independently assign a severity rating to each ADE and pADE.

Conditions

Transitional Care Coordination; Home Visits

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Recently discharged homebound patients

Collaborative visit with provider and pharmacist

Intervention Type: OTHER

Interventions

Collaborative visit with provider and pharmacist

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Adult patients discharged from the hospital in the last 7 days and with more than two chronic conditions and significant obstacles to accessing care in an office setting are eligible for study participation

Exclusion Criteria

• Adult patients able to access care in an office setting.
• Adult patients discharged from the hospital greater than 7 days prior to the office visit.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

American Society of Health-System Pharmacy Foundation

UNKNOWN

Sponsor Role: collaborator

Ohio State University

OTHER

Sponsor Role: lead

Responsible Party

Stuart Beatty

Assistant Professor of Clinical Pharmacy

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

The Ohio State University Division of General Internal Medicine Martha Morehouse

Columbus, Ohio, United States

Countries

United States

Other Identifiers

2013H0185

Identifier Type: -

Identifier Source: org_study_id