Medication Review in Chronic Complex or Polymedicated Patients After Hospital Discharge.
NCT ID: NCT05799430
Last Updated: 2023-09-15
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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UNKNOWN
NA
372 participants
INTERVENTIONAL
2023-04-15
2024-07-31
Brief Summary
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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?
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Detailed Description
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Patients in the control group will receive usual care.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
SINGLE
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.
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
Control group
The control group will receive usual care.
Control group
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
Control group
Usual care by FP an PCN
Eligibility Criteria
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Inclusion Criteria
* Polypharmacy: ten o more drugs prescribed in a chronic schedule OR
* Complez Chronic Condition
Exclusion Criteria
* Major mental health disorder
* Patient on dialysis
* Organ transplant patients
65 Years
ALL
No
Sponsors
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Andalusian Health Service
OTHER_GOV
Fundación Pública Andaluza para la gestión de la Investigación en Sevilla
OTHER
Responsible Party
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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
Countries
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Central Contacts
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Facility Contacts
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References
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Rodriguez-Perez A, Alfaro-Lara ER, Sierra-Torres MI, Villalba-Moreno A, Nieto-Martin MD, Galvan-Banqueri M, Santos-Ramos B. Validation of the LESS-CHRON criteria: reliability study of a tool for deprescribing in patients with multimorbidity. Eur J Hosp Pharm. 2019 Nov;26(6):334-338. doi: 10.1136/ejhpharm-2017-001476. Epub 2018 May 30.
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Related Links
Access external resources that provide additional context or updates about the study.
Estrategia para la seguridad del paciente. Plan estratégico de calidad del Sistema Sanitario Público de Andalucía. Consejería de Salud y Familias. 2019
Lown Institute. Medication Overload: America's Other Drug Problem. How the drive to prescribe is harming older adults. 2019
Scottish Government Polypharmacy Model of Care Group. Polypharmacy Guidance, Realistic Prescribing. 3ª edition, 2018. Scottish Government
Medicines Optimization. Quality standard \[QS120\] NICE. 2016
Atención a Pacientes Pluripatológicos. Proceso Asistencial Integrado. Consejería de Salud 2018.
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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