Eliminating Risk of Preventable Adverse Drug Events at the Hospital-community Interface of Care (CMR)

Eliminating Risk of Preventable Adverse Drug Events at the Hospital-community Interface of Care: to Develop and Test a Community-based Medication Reconciliation Program and a Risk Prediction Model That Identifies High-risk Patient Groups

This initiative aims to decrease the risk of medication errors at the hospital-community interface as well as health system utilization following hospital discharge by implementing a pharmacist-led medication reconciliation in the patients' home within 72 hours of hospital discharge.

Study Overview

• Status: Completed
• Conditions: Adverse Drug Events
• Intervention / Treatment: Behavioral: Medication Reconciliation

Detailed Description

The goals of this initiative are to decrease the risk for medication errors at the hospital community interface of care, thus decreasing preventable adverse drug events and preventable drug-related health system utilization following hospital discharge. This initiative has four objectives that aim to:

1. Develop and test a community-based medication reconciliation process/intervention.
2. Design and conduct a randomized controlled trial to examine the impact of the intervention on post-discharge health services utilization by comparing a set of outcome variables between intervention and non-intervention groups.
3. Design a risk prediction model that helps identify patients discharged from in-patient care with the highest level of need for the intervention.
4. Determine whether a community-based medication reconciliation process/intervention adds risk reduction value to individuals who have undergone an in-hospital medication reconciliation.

• Study Type: Interventional
• Enrollment (Actual): 156
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Stony Plain, Alberta, Canada, T7Z 2M7
      • Westview Health Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Patients attending the WestView Health Centre Medicine/Family Health Unit with at least one medication at discharge.

Exclusion Criteria:

• First Nations persons
• Residents of continuing care or assisted living facilities
• Persons not residing in the Edmonton, AB, Canada region
• Persons who obtain a score of 19 or less on the Mini Mental State Examination (MMSE)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Medication Reconciliation Intervention; Participants receiving a pharmacist-led home intervention conducted within 72 hours of hospital discharge aimed at identifying and correcting medication discrepancies.	Behavioral: Medication Reconciliation; A pharmacist-led home intervention conducted within 72 hours of hospital discharge aimed at correcting and identifying medication discrepancies.
No Intervention: Medication Reconciliation Non-Interven.; Participants not receiving a pharmacist-led home intervention conducted within 72 hours of hospital discharge aimed at identifying and correcting medication discrepancies.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Health Services Utilization 3 Months Following Hospital Discharge	Mean health services utilization 3 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments.	3 Months
Health Services Utilization 6 Months Following Hospital Discharge	Mean health services utilization 6 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments.	6 Months
Health Services Utilization 9 Months Following Hospital Discharge	Mean health services utilization 9 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments.	9 Months
Health Services Utilization 12 Months Following Hospital Discharge	Mean health services utilization 12 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments.	12 months
Health Services Utilization 18 Months Following Hospital Discharge	Mean health services utilization 18 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments.	18 months

Collaborators and Investigators

• Sponsor: Westview Physician Collaborative
• Investigators: Principal Investigator: Allan Bailey, M.D., Westview Physician Collaborative; Study Director: Grace Moe, M.Sc.P.T., WestView Primary Care Network

Study record dates

Study Major Dates

• Study Start: November 1, 2008
• Primary Completion (Actual): February 1, 2013
• Study Completion (Actual): February 1, 2013

Study Registration Dates

• First Submitted: July 14, 2010
• First Submitted That Met QC Criteria: July 15, 2010
• First Posted (Estimate): July 16, 2010

Study Record Updates

• Last Update Posted (Estimate): February 15, 2013
• Last Update Submitted That Met QC Criteria: February 12, 2013
• Last Verified: February 1, 2013

More Information

Terms related to this study

• Keywords: Medication Reconciliation; Adverse Drug Events; Pharmacist-led Intervention
• Additional Relevant MeSH Terms: Chemically-Induced Disorders; Drug-Related Side Effects and Adverse Reactions
• Other Study ID Numbers: CMPA#2026