Effects of Pharmacist-led Medication Reconciliation Services on Geriatric Patients

NCT ID: NCT06610292

Last Updated: 2024-09-24

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 128 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-06-24
• Study Completion Date: 2018-10-13

Brief Summary

This study aims to assess the effects of Pharmacist-led medication reconciliation on hospitalized elderly patients aged above 65 at a leading tertiary military hospital in Jordan.

Detailed Description

A four-month randomized controlled trial was conducted at King Hussein Medical Hospital (KHMH), one of the Royal Military Medical Services (RMS) tertiary hospitals located in central Amman. During the study period, 128 patients were selected using convenience sampling. Later, medication histories were compared between pre-admission and admission records to obtain the Best Possible Medication History (BPMH) and identify medication discrepancies, which were categorized as either intentional (documentation errors) or unintentional discrepancies.

The already selected patients were randomly allocated into two groups (intervention and control groups). Then, Pharmacist-led medication reconciliation services were provided to the intervention group and standard care was provided to the control group. Also at discharge the number of medication discrepancies was documented. Linear regression analysis was performed to assess risk factors associated with the occurrence of unintentional discrepancies.

Within 30 days post-discharge, patients were assessed for any hospital re-admissions, emergency department visits and medication-related side effects.

Conditions

Geriatric Patients; Medication Reconcilitation Upon Hospital Admission; Medication Reconciliation At Discharge; Pharmacist-led Medication Reconciliation

Study Design

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

Study Groups

Control group

Patients did not receive Pharmacist-led medication reconciliation services

Group Type: NO_INTERVENTION

No interventions assigned to this group

Intervention group

Patients received Pharmacist-led medication reconciliation services

Group Type: EXPERIMENTAL

Pharmacist-led medication reconciliation services

Intervention Type: OTHER

Upon admission, information about patients Best Possible Medication History (BPMH) was extracted. Information on current medications, both regular and as-needed, was also recorded. All data were cross-referenced with the electronic records and verified through patients or caregivers interviews to create a comprehensive medication list.

Then, comparison was conducted between standard care medication list and Pharmacist-led medication reconciliation list to identify any possible medication discrepancies. Also, during hospital stay and upon discharge emerging medication discrepancies were assessed and resolved.

Moreover, the impacts on healthcare resources utilization within 30 days post-discharge was measured. This includes evaluating hospital re-admissions, emergency department visits, and the occurrence of any adverse drug events (ADEs).

Interventions

Pharmacist-led medication reconciliation services

Upon admission, information about patients Best Possible Medication History (BPMH) was extracted. Information on current medications, both regular and as-needed, was also recorded. All data were cross-referenced with the electronic records and verified through patients or caregivers interviews to create a comprehensive medication list.

Then, comparison was conducted between standard care medication list and Pharmacist-led medication reconciliation list to identify any possible medication discrepancies. Also, during hospital stay and upon discharge emerging medication discrepancies were assessed and resolved.

Moreover, the impacts on healthcare resources utilization within 30 days post-discharge was measured. This includes evaluating hospital re-admissions, emergency department visits, and the occurrence of any adverse drug events (ADEs).

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Newly admitted patient within no more than 24 hours and anticipated to stay in the hospital for more than 48 hours.
• Geriatrics patients defined as those aged (≥65 years) (Orimo et al., 2006).
• Prescribed at least one chronic medication prior to the study admission.

Exclusion Criteria

• Patient admitted to the critical care or isolation units or in unconscious or comatose states.
• Patients if they were discharged against medical advice.

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Jordanian Royal Medical Services

OTHER

Sponsor Role: collaborator

Royal Medical Services, Jordanian Armed Forces

OTHER

Sponsor Role: collaborator

University of Jordan

OTHER

Sponsor Role: lead

Responsible Party

Majed Shafaamri

Research Assistant

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Eman A Hammad

Role: PRINCIPAL_INVESTIGATOR

Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan

Locations

University of Jordan

Amman, , Jordan

Countries

Jordan

Other Identifiers

6/2018

Identifier Type: -

Identifier Source: org_study_id