Evaluation of the Impact of a Collaboration Between Hospital and Community Pharmacists at Hospital Discharge

NCT ID: NCT06902779

Last Updated: 2025-09-15

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

RECRUITING

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-01

Study Completion Date

2026-07-01

Brief Summary

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The aim of this study is to evaluate the impact of an enhanced collaboration between a hospital pharmacist and a community pharmacist during hospital discharge. For patients taking multiple medications, hospitalization often involves numerous changes to their treatment regimen. For community pharmacies, discharge prescriptions are often complex, and they sometimes lack the information that pharmacists need to deliver the treatment as safely as possible. As a result, there is a risk of medication errors, and a risk for patients. We aim to evaluate the benefits of this collaboration for adult patients admitted to the internal medicine ward of a regional hospital who are taking seven or more drugs and are being discharged to home.

The main question it aims to answer is : Does the enhanced collaboration reduce the number of drug-related problems encountered by community pharmacists with discharge prescriptions ? Researchers will compare patients when a hospital pharmacist is involved during the discharge process and when he or she is not involved, which corresponds to normal care.

The hospital pharmacist will not perform the intervention directly on the patient, but only with the community pharmacy. Once they agree to participate in the study, patients will only have to go to their usual community pharmacy after discharge and accept that the hospital transmits medical information to their usual pharmacy.

Detailed Description

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Conditions

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Polypharmacy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Control arm

Participants in the control arm will benefit from the usual standard of care currently provided in routine clinical practice. Physicians performs medication reconciliation on their own and hand-out the prescription to the patient the day of discharge. The patient then goes to the pharmacy for a classical drug dispensation.

Group Type NO_INTERVENTION

No interventions assigned to this group

Intervention arm

Participants in the intervention group will benefit from the hospital pharmacist's support to optimize medication management and ensure a safe and effective discharge process.

Group Type EXPERIMENTAL

Support of the hospital pharmacist for the medication management at hospital discharge

Intervention Type OTHER

1\) The hospital pharmacist calls the community pharmacy the day before discharge to order unusual or specific medications 2) The day of discharge, the hospital pharmacist performs a medication reconciliation in collaboration with the hospital physician 3) Once completed, the discharge prescription is sent to the community pharmacy before the patient is discharged. 4) The hospital pharmacist calls the community pharmacy to provide additional information about the patient and the prescription and to answer any questions. Additional information will help the community pharmacist to understand the prescription : administrative data, clinical data, medication-related information, patient follow-up and patient concerns.

Interventions

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Support of the hospital pharmacist for the medication management at hospital discharge

1\) The hospital pharmacist calls the community pharmacy the day before discharge to order unusual or specific medications 2) The day of discharge, the hospital pharmacist performs a medication reconciliation in collaboration with the hospital physician 3) Once completed, the discharge prescription is sent to the community pharmacy before the patient is discharged. 4) The hospital pharmacist calls the community pharmacy to provide additional information about the patient and the prescription and to answer any questions. Additional information will help the community pharmacist to understand the prescription : administrative data, clinical data, medication-related information, patient follow-up and patient concerns.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients admitted to the internal medicine ward for more than 48 hours
* Patients prescribed seven or more drugs at the time of screening
* Patients discharged to home
* Patients able to give informed consent as documented by signature

Exclusion Criteria

* Patient discharged to another hospital, nursing home or rehabilitation clinic
* Refusal of the community pharmacy to participate
* Inability to sign consent and follow the procedures of the study, due to language problems, psychological disorders, dementia, alterations of consciousness and lack of judgement
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pharmacie des Hopitaux de l'Est Lemanique

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anne-Laure Blanc, PharmD, PhD

Role: STUDY_DIRECTOR

Pharmacie des Hôpitaux de l'Est Lémanique

Locations

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Hôpital Riviera-Chablais, Vaud-Valais

Rennaz, Canton of Vaud, Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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Paul Garin, PharmD

Role: CONTACT

+41 79 534 21 36

Anne-Laure Blanc, PharmD, PhD

Role: CONTACT

+41 58 773 45 43

Facility Contacts

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Paul Garin, PharmD

Role: primary

+41 79 534 21 36

References

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Michel B, Hemery M, Rybarczyk-Vigouret MC, Wehrle P, Beck M. Drug-dispensing problems community pharmacists face when patients are discharged from hospitals: a study about 537 prescriptions in Alsace. Int J Qual Health Care. 2016 Dec 1;28(6):779-784. doi: 10.1093/intqhc/mzw111.

Reference Type BACKGROUND
PMID: 27655792 (View on PubMed)

Braund R, Coulter CV, Bodington AJ, Giles LM, Greig AM, Heaslip LJ, Marshall BJ. Drug related problems identified by community pharmacists on hospital discharge prescriptions in New Zealand. Int J Clin Pharm. 2014 Jun;36(3):498-502. doi: 10.1007/s11096-014-9935-8. Epub 2014 Apr 4.

Reference Type BACKGROUND
PMID: 24700340 (View on PubMed)

Imfeld-Isenegger TL, Studer H, Ceppi MG, Rosen C, Bodmer M, Beeler PE, Boeni F, Haring AP, Hersberger KE, Lampert ML. Detection and resolution of drug-related problems at hospital discharge focusing on information availability - a retrospective analysis. Z Evid Fortbild Qual Gesundhwes. 2021 Nov;166:18-26. doi: 10.1016/j.zefq.2021.08.004. Epub 2021 Sep 15.

Reference Type BACKGROUND
PMID: 34538579 (View on PubMed)

Ahmad A, Mast MR, Nijpels G, Elders PJ, Dekker JM, Hugtenburg JG. Identification of drug-related problems of elderly patients discharged from hospital. Patient Prefer Adherence. 2014 Feb 4;8:155-65. doi: 10.2147/PPA.S48357. eCollection 2014.

Reference Type BACKGROUND
PMID: 24523581 (View on PubMed)

Maes KA, Studer H, Berger J, Hersberger KE, Lampert ML. Documentation of pharmaceutical care: Validation of an intervention oriented classification system. J Eval Clin Pract. 2017 Dec;23(6):1425-1432. doi: 10.1111/jep.12817. Epub 2017 Sep 29.

Reference Type BACKGROUND
PMID: 28960678 (View on PubMed)

Mekonnen AB, McLachlan AJ, Brien JA. Pharmacy-led medication reconciliation programmes at hospital transitions: a systematic review and meta-analysis. J Clin Pharm Ther. 2016 Apr;41(2):128-44. doi: 10.1111/jcpt.12364. Epub 2016 Feb 23.

Reference Type BACKGROUND
PMID: 26913812 (View on PubMed)

McCarthy LM, Li S, Fernandes O, Cameron K, Lui P, Wong G, Pariser P, Farrell J, Luke MJ, Guilcher SJT. Enhanced communication between inpatient and community pharmacists to optimize medication management during transitions of care. J Am Pharm Assoc (2003). 2019 Jan-Feb;59(1):79-86.e1. doi: 10.1016/j.japh.2018.09.006. Epub 2018 Nov 13.

Reference Type BACKGROUND
PMID: 30446423 (View on PubMed)

Bruhwiler LD, Hersberger KE, Lutters M. Hospital discharge: What are the problems, information needs and objectives of community pharmacists? A mixed method approach. Pharm Pract (Granada). 2017 Jul-Sep;15(3):1046. doi: 10.18549/PharmPract.2017.03.1046. Epub 2017 Aug 25.

Reference Type BACKGROUND
PMID: 28943987 (View on PubMed)

Grandchamp S, Blanc AL, Roussel M, Tagan D, Sautebin A, Dobrinas-Bonazzi M, Widmer N. Pharmaceutical Interventions on Hospital Discharge Prescriptions: Prospective Observational Study Highlighting Challenges for Community Pharmacists. Drugs Real World Outcomes. 2022 Jun;9(2):253-261. doi: 10.1007/s40801-021-00288-x. Epub 2021 Dec 31.

Reference Type BACKGROUND
PMID: 34971408 (View on PubMed)

Redmond P, Grimes TC, McDonnell R, Boland F, Hughes C, Fahey T. Impact of medication reconciliation for improving transitions of care. Cochrane Database Syst Rev. 2018 Aug 23;8(8):CD010791. doi: 10.1002/14651858.CD010791.pub2.

Reference Type BACKGROUND
PMID: 30136718 (View on PubMed)

Ensing HT, Stuijt CC, van den Bemt BJ, van Dooren AA, Karapinar-Carkit F, Koster ES, Bouvy ML. Identifying the Optimal Role for Pharmacists in Care Transitions: A Systematic Review. J Manag Care Spec Pharm. 2015 Aug;21(8):614-36. doi: 10.18553/jmcp.2015.21.8.614.

Reference Type BACKGROUND
PMID: 26233535 (View on PubMed)

Mekonnen AB, McLachlan AJ, Brien JA. Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: a systematic review and meta-analysis. BMJ Open. 2016 Feb 23;6(2):e010003. doi: 10.1136/bmjopen-2015-010003.

Reference Type BACKGROUND
PMID: 26908524 (View on PubMed)

Villeneuve Y, Courtemanche F, Firoozi F, Gilbert S, Desbiens MP, Desjardins A, Dinh C, LeBlanc VC, Attia A. Impact of pharmacist interventions during transition of care in older adults to reduce the use of healthcare services: A scoping review. Res Social Adm Pharm. 2021 Aug;17(8):1361-1372. doi: 10.1016/j.sapharm.2020.11.006. Epub 2020 Nov 13.

Reference Type BACKGROUND
PMID: 33250364 (View on PubMed)

Banholzer S, Dunkelmann L, Haschke M, Derungs A, Exadaktylos A, Krahenbuhl S, Liakoni E. Retrospective analysis of adverse drug reactions leading to short-term emergency hospital readmission. Swiss Med Wkly. 2021 Jan 20;151:w20400. doi: 10.4414/smw.2021.20400. eCollection 2021 Jan 18.

Reference Type BACKGROUND
PMID: 33516159 (View on PubMed)

Forster AJ, Murff HJ, Peterson JF, Gandhi TK, Bates DW. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003 Feb 4;138(3):161-7. doi: 10.7326/0003-4819-138-3-200302040-00007.

Reference Type BACKGROUND
PMID: 12558354 (View on PubMed)

Other Identifiers

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ECHOPHARM

Identifier Type: -

Identifier Source: org_study_id

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