Effect of a trAnSitional Pharmacist Intervention in geRiatric Inpatients on Hospitals Visits After dischargE
NCT ID: NCT04617340
Last Updated: 2025-04-16
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
827 participants
INTERVENTIONAL
2021-02-25
2024-09-27
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
OTHER
NONE
Study Groups
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Usual care group
No pharmacist will be actively involved in the medication review, counseling or discharge and post-discharge procedure. In both groups the best possible preadmission drug list will be compiled for inpatients within 72 hours after admission to the geriatric ward. If potentially dangerous or life-threatening drug errors are observed in the usual care group, this will be communicated to the treating physician
No interventions assigned to this group
Intervention group
The clinical pharmacist-collaborative service in the intervention group comprises six steps based on the clinical pharmacy intervention proposal of Van der Linden et al (Drugs Aging 2020).
The first three steps focus on optimizing the drug therapy of geriatric inpatients. The remaining steps target a safe transition from the hospital to the community.
Multifaceted clinical pharmacy intervention
1. Assessing patient and caregiver preferences
2. Medication reconciliation on admission
3. Performing a comprehensive medication review before discharge
4. Promoting safe transition
4.a. Compiling a patient friendly medication list
4.b.Optimizing communication with healthcare providers in primary care:
4.b.i.Providing a copy of the medication list for the community pharmacist
4.b.ii. Contacting the general practitioner by phone
4.b.iii. Contacting, if applicable the home care nurse or the nurse from the nursing home by phone.
5.A motivation interview will take place before discharge with patients and caregivers
6.Post-discharge follow-up: 6.a.Follow-up call to discuss potential drug therapy issues, therapy adherence and to resolve any pending issues 6.b.A telepharmacology service will be provided to primary healthcare professionals as a means to consult the ward-based clinical pharmacists and/or research team after discharge.
Interventions
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Multifaceted clinical pharmacy intervention
1. Assessing patient and caregiver preferences
2. Medication reconciliation on admission
3. Performing a comprehensive medication review before discharge
4. Promoting safe transition
4.a. Compiling a patient friendly medication list
4.b.Optimizing communication with healthcare providers in primary care:
4.b.i.Providing a copy of the medication list for the community pharmacist
4.b.ii. Contacting the general practitioner by phone
4.b.iii. Contacting, if applicable the home care nurse or the nurse from the nursing home by phone.
5.A motivation interview will take place before discharge with patients and caregivers
6.Post-discharge follow-up: 6.a.Follow-up call to discuss potential drug therapy issues, therapy adherence and to resolve any pending issues 6.b.A telepharmacology service will be provided to primary healthcare professionals as a means to consult the ward-based clinical pharmacists and/or research team after discharge.
Eligibility Criteria
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Inclusion Criteria
* A written informed consent by the patient or his/her representative
* Discharged from the hospital
Exclusion Criteria
* Unable to understand Dutch
* Being in a palliative stage as stated in their medical record with active withdrawal of drug therapy
* Patients being discharged to another ward within the same hospital or to another hospital
ALL
No
Sponsors
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Universitaire Ziekenhuizen KU Leuven
OTHER
Responsible Party
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Principal Investigators
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Jos Tournoy, prof
Role: PRINCIPAL_INVESTIGATOR
Department of Public Health and Primary care, KU Leuven, Leuven
Locations
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University Hospitals Leuven
Leuven, , Belgium
Countries
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References
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Van der Linden L, Hias J, Walgraeve K, Flamaing J, Tournoy J, Spriet I. Clinical Pharmacy Services in Older Inpatients: An Evidence-Based Review. Drugs Aging. 2020 Mar;37(3):161-174. doi: 10.1007/s40266-019-00733-1.
Hias J, Hellemans L, Laenen A, Walgraeve K, Liesenborghs A, De Geest S, Luyten J, Spriet I, Flamaing J, Van der Linden L, Tournoy J. The effect of a trAnSitional Pharmacist Intervention in geRiatric inpatients on hospital visits after dischargE (ASPIRE): Protocol for a randomized controlled trial. Contemp Clin Trials. 2022 Aug;119:106853. doi: 10.1016/j.cct.2022.106853. Epub 2022 Jul 14.
Other Identifiers
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S64758
Identifier Type: -
Identifier Source: org_study_id
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