- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03786978
Pharmaceutical Care in the Reduction of Readmission Rates in Diabetes Melitus
Impact of a Pharmaceutical Care Model in the Reduction of Readmission Rate in Diabetes Melitus Patients in a Public University Hospital, South Brazil
Diabetes mellitus (DM) is associated with the frequent use of polypharmacy at different times of administration and requires special attention from the patient or caregivers in order to properly treatment performed. The degree of Functional Literacy in Health is defined as the ability to apply literacy skills to health-related materials, including prescriptions, package inserts, and home care instructions. Several questionnaires are used in research and clinical practice to assess the pronunciation and understanding of commonly used medical terms, as the SAHLPA-18 (Short Assessment of Health Literacy for Portuguese Speaking Adults). The Brief Medication Questionnaire (BMQ) evaluates adherence to medication use from a patient's perspective.
During the basal visit, after the characterization of the sample (n= 100), inpatients from Hospital de Clínicas de Porto Alegre (HCPA) were randomized to interventional or comparator group. The interventional group was follow up during a year after basal discharge. Comparator group received only a phone call, 30 days after the basal discharge, to question how was their healthy status. Readmission rates were evaluated for both groups. Also, a economic evaluation was made to measure the readmission rates in terms of costs.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The first outcome of the clinical study was to measure the readmission rate through a structured pharmaceutical care model after basal hospital discharge and measure the effect of this intervention in terms of readmission reduction in a short term period of 30 days, regardless of the hospitalization reason.
As secondary outcomes the investigators measured the readmission rates after basal hospital discharge and the effect of the intervention in terms of readmission reduction in 60, 90,180 and 365 days after basal hospital discharge. Also, the readmission costs in terms of cost-effectiveness were evaluate.
The sample consisted of 100 patients with DM associated with other comorbidities, hospitalized for any reason in the HCPA, of both sexes, older than 18 years.
Informed consent, demographic and validated questionnaires data were collected in the basal visit. After that, patients were randomized to:
Group 1: comparator; Group 2: structured pharmaceutical intervention.
Seven days after basal hospital discharge, drugs adherence was verified.
The interventional group received pharmaceutical care at basal hospitalization stay, after randomization, have their prescription reviewed until 7 days after discharge of basal hospitalization and also received structured phone calls and mobile SMS (Short Message Service) during one year follow up (30, 60, 180 and 365 days).
Electronic medical records of the included patients (intervention and comparator groups) were reviewed monthly for 12 months, aiming to identify access to emergency services or hospital readmissions at the HCPA and, consequently, the reasons for readmissions and outcomes.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with DM and other comorbidities hospitalized for any reason at HCPA
- Patients who are literate or have a literate caregiver;
- Signature in the Term of Consent.
Exclusion Criteria:
- Limited ability to communicate and read in Portuguese and absence of responsible caregiver at the patient room;
- Neuropsychiatric diseases (psychosis, delirium or severe dementia);
- Terminal illness;
- Transplanted patients or users of warfarin, as these patients receive formal guidance from the HCPA pharmaceutical team;
- Auditory or visual impairment that, at the discretion of the investigator, prevents the patient from participating in the study;
- Do not have own mobile number or a close family member living in the same household.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Structured pharmaceutical care
Patients receive a structured pharmaceutical care until one year after hospital discharge
|
Patients receive a structured pharmaceutical care from one year after basal hospital discharge
|
ACTIVE_COMPARATOR: Comparator group
Patient received a single phone call 30 days after basal hospital discharge.
|
Patient received a single phone call 30 days after basal hospital discharge.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Short term readmission rate
Time Frame: 30 days after basal hospital discharge
|
Hospital readmissions after basal hospital discharge
|
30 days after basal hospital discharge
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Readmission rate - 60 days
Time Frame: 60 days after basal hospital discharge
|
Hospital readmissions after basal hospital discharge
|
60 days after basal hospital discharge
|
Readmission rate - 90 days
Time Frame: 90 days after basal hospital discharge
|
Hospital readmissions after basal hospital discharge
|
90 days after basal hospital discharge
|
Long term readmission rate- 180 days
Time Frame: 180 days after basal hospital discharge
|
Hospital readmissions after basal hospital discharge
|
180 days after basal hospital discharge
|
Long term readmission rate- 365 days
Time Frame: 365 days after basal hospital discharge
|
Hospital readmissions after basal hospital discharge
|
365 days after basal hospital discharge
|
Economic evaluation
Time Frame: 365 days
|
Comparison between costs from readmission in both randomized groups
|
365 days
|
Collaborators and Investigators
Investigators
- Principal Investigator: Ticiana C Rodrigues, PhD, Federal University of Health Science of Porto Alegre
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 150118
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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