Medication Review in Chronic Complex or Polymedicated Patients After Hospital Discharge.

NCT ID: NCT05799430

Last Updated: 2023-09-15

Study Results

Results pending

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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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

372 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-15

Study Completion Date

2024-07-31

Brief Summary

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The goal of this prospective multicentre clustered randomized controlled trial is to evaluate the effect on new hospitalization episodes of a multidisciplinary medication review in primary care patients with polypharmacy or chronic complex conditions after hospital discharge.

The multidisciplinary team will be integrated by a family physician (FP), a primary care nurse (PCN) and a primary care pharmacist (PCP). Patient will be adults aged 65 years and older. Polypharmacy refers to the use of 10 or more drugs based on information in electronic prescription software.

Research questions are:

In elderly patients with polypharmacy, which is the effect of an interdisciplinary medication review after hospital discharge in comparison with standard care, in terms of:

* new hospitalization episodes?
* number of drugs prescribed?
* prescribed drugs adequacy?

Detailed Description

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Centres will be randomized to medication review intervention or usual care group. Eligible patients will be ask for informed consent. For patients in the intervention group, PCP will collect information about prescribed medication and diseases from the electronic health record and e-prescribing application. The medication review in primary care will be focus to reconcile the medications the patient was taking prior to admission and those initiated in hospital, with the medications they should be taking post-discharge to ensure all changes are intentional and that discrepancies are resolved as soon as possible. The review process will include detection of potential drugs interactions, wrong doses, lack of adherence (based on dispensing recorded data) and adequacy to explicit criteria for potentially inappropriate prescriptions included in different tools: a) STOPP-STAR, STOPP-Pal, LESS-CHRON lists; b) Guideline for Medication Review in Primary Care, a local publication and c) Medication review in patients with polypharmacy. A list of drugs frequently associate with potentially inappropriate prescriptions. Andalusian health Service). PCP will write a report to communicate the results of medication review to primary care physician and nurse. The multidisciplinary team will define a personalized therapeutic plan to be implemented for every patient.

Patients in the control group will receive usual care.

Conditions

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Medication Review Polypharmacy Disease, Chronic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A cluster-randomized control trial
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Intervention

The intervention group will receive a multidisciplinary medication review and a personalized therapeutic plan in the following 72 hours after hospital discharge. The intervention will be developed by a multidisciplinary team that includes a family physician (FP), a primary care nurse (PCN) and a primary care pharmacist (PCP). PCP is a pharmacist working in a full-time base for the Pharmacy Service in a Primary Care District in Andalusian Public Health Service.

Group Type EXPERIMENTAL

Multidisciplinary medication review

Intervention Type BEHAVIORAL

FP communicate to the PCP patients recently discharged. The medication review process consists in 5 steps:

1. PCP perform a structured drug review based on information from health record and e-prescribing application. The drug review comprise the appraisal of potentially inappropriate medication based on lists of explicit criteria.
2. PCP communicates and discuss the results of medication review with GP and PCN, in a brief meeting face-to-face, with possible adaptation of the recommendations.
3. FP, PCN and PCP agree on a personalized therapeutic plan for the patient that includes actions to optimize the therapy.
4. FP and PCN share plan with the patient and/or carer with possible adaptation of the recommendations and agree about actions to be implemented.
5. FP and PCN communicate to PCP final agreement with patient and/or carer
6. FP and/or PCN follow-up implantation of agreed recommendations using standard health care procedures

Control group

The control group will receive usual care.

Group Type ACTIVE_COMPARATOR

Control group

Intervention Type BEHAVIORAL

Usual care by FP an PCN

Interventions

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Multidisciplinary medication review

FP communicate to the PCP patients recently discharged. The medication review process consists in 5 steps:

1. PCP perform a structured drug review based on information from health record and e-prescribing application. The drug review comprise the appraisal of potentially inappropriate medication based on lists of explicit criteria.
2. PCP communicates and discuss the results of medication review with GP and PCN, in a brief meeting face-to-face, with possible adaptation of the recommendations.
3. FP, PCN and PCP agree on a personalized therapeutic plan for the patient that includes actions to optimize the therapy.
4. FP and PCN share plan with the patient and/or carer with possible adaptation of the recommendations and agree about actions to be implemented.
5. FP and PCN communicate to PCP final agreement with patient and/or carer
6. FP and/or PCN follow-up implantation of agreed recommendations using standard health care procedures

Intervention Type BEHAVIORAL

Control group

Usual care by FP an PCN

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

\- Hospital discharge in the last 48 h and one of the following conditions:

* Polypharmacy: ten o more drugs prescribed in a chronic schedule OR
* Complez Chronic Condition

Exclusion Criteria

* Patients in last days of life
* Major mental health disorder
* Patient on dialysis
* Organ transplant patients
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Andalusian Health Service

OTHER_GOV

Sponsor Role collaborator

Fundación Pública Andaluza para la gestión de la Investigación en Sevilla

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Teresa Molina, Pharm Dr

Role: PRINCIPAL_INVESTIGATOR

Andalusian Health Service. Spain

Locations

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Sevilla Primary Care District

Seville, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Teresa Molina-López, Pharm Dr

Role: CONTACT

637642 411+

Daniel Palma-Morgado, Pharm G

Role: CONTACT

Facility Contacts

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Teresa Molina-López, Pharm.Dr.

Role: primary

+34637642411

Daniel Palma-Morgado, Pharm. Bch.

Role: backup

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Related Links

Access external resources that provide additional context or updates about the study.

https://juntadeandalucia.es/export/drupaljda/EstrategiaISeguridadPaciente_v5.pdf

Estrategia para la seguridad del paciente. Plan estratégico de calidad del Sistema Sanitario Público de Andalucía. Consejería de Salud y Familias. 2019

https://lowninstitute.org/wp-content/uploads/2019/08/medication-overload-lown-web.pdf

Lown Institute. Medication Overload: America's Other Drug Problem. How the drive to prescribe is harming older adults. 2019

https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/09/Polypharmacy-Guidance-2018.pdf

Scottish Government Polypharmacy Model of Care Group. Polypharmacy Guidance, Realistic Prescribing. 3ª edition, 2018. Scottish Government

https://www.nice.org.uk/guidance/qs120

Medicines Optimization. Quality standard \[QS120\] NICE. 2016

https://juntadeandalucia.es/export/drupaljda/salud_5af1956d9925c_atencion_pacientes_pluripatologicos_2018.pdf

Atención a Pacientes Pluripatológicos. Proceso Asistencial Integrado. Consejería de Salud 2018.

https://juntadeandalucia.es/export/drupaljda/PlanAtencEECC.pdf

Plan Andaluz de Atención Integrada a Pacientes con Enfermedades Crónicas. Consejería de Salud. 2012

Other Identifiers

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S0502

Identifier Type: -

Identifier Source: org_study_id

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