Effect of Medication Management at Home Via Pharmacy Home Televisits

NCT ID: NCT04340570

Last Updated: 2026-01-08

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 304 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-07-16
• Study Completion Date: 2025-12-31

Brief Summary

Older Veterans, particularly those with multiple chronic conditions requiring complex medication regimens, are more susceptible to adverse effects of medications. In this study, the investigators will examine the effect of a pharmacist led medication management intervention delivered by home televisit on improving medication use. The investigators anticipate that televisit to home by pharmacist for medication management may enhance use of medications at home by Veterans particularly those with complex medication regimens.

Detailed Description

Older adults are more likely to suffer from multiple chronic conditions, to be prescribed multiple medications, and are more susceptible to adverse effects of medications. In addition, older adults often use over-the-counter medications and supplements, further complicating their medication regimen. Complex medication regimens are potentially harmful to older adults due to potential drug interactions, potentially inappropriate prescribing or over-the-counter drug use, and medication non-adherence that may lead to poor control of chronic disease. Interventions aimed at reducing medication discrepancy in the ambulatory clinic setting, such as the review of written medication lists, and implementation of "brown bag" reconciliation (asking patients to bring in all medication bottles for review in the clinic) continues to be challenging and have limited success. Clinical pharmacist led interventions to improve appropriate medication use in older adults, including the application of the START/STOPP criteria, have demonstrated effectiveness in reducing adverse drug events. With the increased capability of VA telemedicine to reach Veteran in their homes, delivering medication management via televisit by clinical pharmacists has the potential to yield similar benefits for a larger number of older Veterans.

Telemedicine is an increasingly vital component within VHA to increase access and improve quality of care. By extending care beyond brick-and-mortar clinics, telemedicine increases the reach of care teams and is more convenient for patients, resulting in improved patient satisfaction. Using the capability of telemedicine to reach patients' homes, the investigators propose to examine the effect of medication management by clinical pharmacists via home video televisits, as home video visits have the potential to provide direct visualization of medications in older adults' homes, thereby reducing medication discrepancy and increasing medication adherence. Pharmacist management for older adult medication regimen may also improve appropriate medication use in older adults through direct pharmacist-patient interview and education. In support of this application, preliminary data from the team of investigators demonstrate acceptability of video televisits by older adults, that there is good uptake by patients and VA providers, and that video televisits into the home are feasible.

In this study, the investigators aim to develop a protocol for pharmacy home televisits for medication management in older adults who have multiple chronic conditions and are on multiple medications. The investigators will then conduct a randomized trial to examine the effect of these televisits on appropriate medication use, medication discrepancies, adherence and adverse drug events. The investigators anticipate that a pharmacist led medication management home televisit intervention will lead to reduction in potentially inappropriate use of medication, reduction in medication discrepancies, increased medication adherence and reduced adverse drug events in older adults compared to older adults receiving usual care. The investigators will also examine the potential challenges in implementing the intervention so that the study findings may inform future implementation.

Conditions

Polypharmacy; Deprescribing; Telemedicine

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: SINGLE

Study Groups

Intervention

Receives pharmacist home televisit for medication management

Group Type: EXPERIMENTAL

Medication management via televisit to home

Intervention Type: BEHAVIORAL

Pharmacist led home based televisit for medication management

Usual Care

Usual care for outpatient medication management

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Medication management via televisit to home

Pharmacist led home based televisit for medication management

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Had at least 1 VA primary care visit within past year
• At least 2 chronic conditions
• At least 5 daily medications

Exclusion Criteria

• Dementia diagnosis
• Lacks capacity for informed consent

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

VA Office of Research and Development

FED

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

William W Hung, MD AB MPH

Role: PRINCIPAL_INVESTIGATOR

James J. Peters Veterans Affairs Medical Center

Lauren Rachel Moo, MD

Role: PRINCIPAL_INVESTIGATOR

VA Bedford HealthCare System, Bedford, MA

Locations

VA Bedford HealthCare System, Bedford, MA

Bedford, Massachusetts, United States

James J. Peters VA Medical Center, Bronx, NY

The Bronx, New York, United States

Countries

United States

References

Hawley CE, Wagner C, Venegas MD, Genovese N, Triantafylidis LK, McCullough MB, Beizer JL, Hung WW, Moo LR. Connecting the disconnected: Leveraging an in-home team member for video visits for older adults. J Am Geriatr Soc. 2024 May;72(5):1408-1419. doi: 10.1111/jgs.18663. Epub 2023 Nov 13.

Reference Type: RESULT

PMID: 37960887 (View on PubMed)

Hossain SR, Samant AN, Balsamo BC, Hawley CE, Zanchelli MC, Zhu C, Venegas MD, Robertson M, McCullough MB, Beizer JL, Boockvar KS, Siu AL, Moo LR, Hung WW. Effect of Medication Management at Home via Pharmacist-Led Home Televisits: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc. 2025 Feb 5;14:e65141. doi: 10.2196/65141.

Reference Type: DERIVED

PMID: 39908544 (View on PubMed)

Provided Documents

Document Type: Informed Consent Form

View Document

Other Identifiers

IIR 18-286

Identifier Type: -

Identifier Source: org_study_id