PharmD Transitions of Care Program (PHARMD-TOC): A Community Pharmacy Transitions of Care Program

February 10, 2020 updated by: Candi Morello, University of California, San Diego
Many hospitals and medical groups have developed transitions of care (TOC) programs or procedures in an attempt to reduce hospital readmission and reutilization rates of patients discharged from the hospital. As healthcare's most accessible practitioners, Community Pharmacists have a unique opportunity to assist with reducing unnecessary hospital re-utilization (re-admissions and emergency department visits) after hospital discharge. The purpose of this study is to conduct and evaluate the implementation of a Community Pharmacy-based Transitions of Care (TOC) Program for high-risk post-discharge patients of PIH Health Hospital-Whittier (PIH). The primary objective will be to compare the proportion of patients with hospital re-utilization (readmission, observation status, ED visits) during 30-days post hospital discharge between patients randomly assigned to the PHARMD-TOC group vs. the historic rate at PIH. Secondary analyses will examine differences between groups and describe implementation details of the PHARMD-TOC model of patient care.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Study Type

Interventional

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • - Admission LACE Score: in moderate range (5 to 9) And
  • Taking high risk medication(s): anticoagulants, insulin, oral antiplatelet agents, oral hypoglycemic agents, opioid analgesics, digoxin Or Taking at least 5 medications AND have one of following: CHF, COPD, Asthma, Pneumonia, Diabetes, ESRD, Schizophrenia, Bi-Polar, Dizziness, History of Falls

And

  • Medical or Surgical Unit patients
  • Age > 18 years
  • Being discharged to home (with or without Home Health services)
  • English and/or Spanish speaking
  • Will have access to a telephone post-discharge
  • Ability to give consent
  • Patient admitted to hospital through the emergency department, as a direct admission or as a transfer, or as an elective surgery patient

Exclusion Criteria:

  • - Patients with observation status
  • Caremore Health Plan patients (Caremore has a separate post-discharge program)
  • Patients discharged and followed up by the PIH Coumadin Clinic
  • Patients discharged to Residential MD House Calls program
  • Patients discharged to Skilled Nursing Facility
  • Anyone with planned readmissions
  • Obstetrics patients
  • Hospice patients
  • Oncology patients
  • Anyone who does not meet provisions of protocol
  • Anyone unwilling or unable to give consent for study procedures and data access

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: PHARMD-TOC i
PharmD Follow-Up Post Discharge
Other: PharmD TOC
patients participating in a community pharmacy-based Transitions of Care Program (PHARMD-TOC)
Active Comparator: USUAL CARE
Usual Post Discharge Procedures
Other: Usual Care
patients participating Usual Care discharge services

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion Patients with Hospital Reutilization
Time Frame: 30 days post hospital discharge
proportion of patients with hospital re-utilization (readmission, observation status, ED visits) during 30-days post hospital discharge
30 days post hospital discharge

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of California, San Diego

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 1, 2018

Primary Completion (Actual)

February 10, 2020

Study Completion (Actual)

February 10, 2020

Study Registration Dates

First Submitted

July 31, 2018

First Submitted That Met QC Criteria

July 31, 2018

First Posted (Actual)

August 6, 2018

Study Record Updates

Last Update Posted (Actual)

February 12, 2020

Last Update Submitted That Met QC Criteria

February 10, 2020

Last Verified

February 1, 2020

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 171847

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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