Patient Pathway Pharmacist - Optimal Drug-related Care

NCT ID: NCT03695081

Last Updated: 2023-06-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-09-03
• Study Completion Date: 2023-06-28

Brief Summary

Medication errors represent the most common cause of patient injury and one of the most frequently reported health related deviation in Norway. The addition of a dedicated clinical pharmacist throughout the hip fracture patient pathway (patient pathway pharmacist) is believed to improve patient safety and ensure optimal drug-related patient care. The pharmacist will perform medication reconciliation at admission to hospital, medication review after surgery and assist physicians with discharge summary. Six weeks after discharge the patient pathway pharmacist will perform a second drug reconciliation and medication review. This study will assess the pharmacists' place and specific tasks in the patient pathway, describe areas where the pharmacist contribute to increased quality of care and assess the benefits and/or disadvantages experienced with introducing a patient pathway pharmacist. The estimated number of patients included is 60. Current practice will be determined by investigating the last 50 patients' medical record and a questionnaire to health care professionals involved in treatment of hip fracture patients. Data from medication reconciliation and drug review will be collected and compared to current practice. After the inclusion period, focus group surveys and/or semi-structured interviews will be executed to describe the perceived improvement in the quality of care. Primary endpoints are: 1) Medication reconciliation score at admission 2) Number of inappropriate drugs for elderly 3) Discharge summary score 4) Discharge summaries following procedure. Secondary endpoints are readmissions and mortality after 30 and 90 days. Qualitative endpoints: 1) Health care professionals experience of current drug-related practice 2) Experienced advantages and disadvantages of a patient pathway pharmacist.

Conditions

Hip Fractures; Aging; Patient Fall

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Patient Pathway Pharmacist intervention

1. Medication reconciliation at admission to hospital

2. Medication review post surgery

3. Optimised list of drugs in the discharge summary, in accordance with hospital procedures

4. Medication reconciliation, six weeks after discharge

5. Medication review, six weeks after discharge

Group Type: EXPERIMENTAL

Patient Pathway Pharmacist intervention

Intervention Type: PROCEDURE

1. Medication reconciliation at admission to hospital

2. Medication review post surgery

3. Optimised list of drugs in the discharge summary, in accordance with hospital procedures

4. Medication reconciliation, six weeks after discharge

5. Medication review, six weeks after discharge

No intervention

Business as usual. The Patient Pathway Pharmacist is not involved and the nurses and physicians are responsible for medicine reconciliation, -review and section in the discharge summary.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Patient Pathway Pharmacist intervention

1. Medication reconciliation at admission to hospital

2. Medication review post surgery

3. Optimised list of drugs in the discharge summary, in accordance with hospital procedures

4. Medication reconciliation, six weeks after discharge

5. Medication review, six weeks after discharge

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Hip fracture patients in Vestfold county, Norway

Exclusion Criteria

• Patients under 18 years
• Terminally ill
• Hip fracture patients who do not follow the standardized patient pathway at Vestfold Regional Hospital
• Patients who do not consent to be included in the study

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

Sponsors

Hospital Pharmacy Enterprise, South Eastern Norway

OTHER

Sponsor Role: collaborator

Sykehuset i Vestfold HF

OTHER

Sponsor Role: lead

Responsible Party

Ben Tore Henriksen

Clinical Pharmacist

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Vestfold Hospital Trust

Tønsberg, , Norway

Countries

Norway

References

Henriksen BT, Krogseth M, Andersen RD, Davies MN, Nguyen CT, Mathiesen L, Andersson Y. Clinical pharmacist intervention to improve medication safety for hip fracture patients through secondary and primary care settings: a nonrandomised controlled trial. J Orthop Surg Res. 2023 Jun 13;18(1):434. doi: 10.1186/s13018-023-03906-2.

Reference Type: DERIVED

PMID: 37312222 (View on PubMed)

Related Links

https://www.itryggehender24-7.no/reduser-pasientskader/legemiddelrelaterte-skader/legemiddelsamstemming-og-legemiddelgjennomgang/_/attachment/download/33b5eb0c-4f62-4d42-862f-b9f95f09423c:12bcc5de3b8e1ff2e4bdb9937951300d8d6f35cc/tiltakspakke-for-samstemming-av-legemiddellister.pdf

Score of the drug section in discharge summaries - The Norwegian Patient Safety Programme: In Safe Hands

Other Identifiers

59475

Identifier Type: -

Identifier Source: org_study_id