- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT05167578
Identifying Reasons for Non-adherence in Patients With Multi-morbidity
Identifying Reasons for Non-adherence in Patients With Multi-morbidity: A Protocol for Prospective Observational Study in Primary Care
Descripción general del estudio
Estado
Intervención / Tratamiento
Descripción detallada
This study aims to identify patient-reported reasons for medication non-adherence during pharmacist-led medication reconciliation in primary care. The investigators will examine medication discrepancies between physicians' prescription orders and patients' self-reported medication use, which medicines patients most often use against physician's order, and the reasons for the variant use of medicines. Additionally, the investigators will study the correlation between medication discrepancies and the number of medicines the patient uses. The investigators also aim to investigate which medicines can be classified as high-risk medicines for non-adherence.
The research method will contain a pharmacist-conducted medication reconciliation including a patient interview in a 30-minute appointment. Physicians, nurses, and pharmacists identify patients who are eligible for this study. The study will include 250 patients who visit the public health centres in Vantaa, Southern Finland.
Medication reconciliation will take place at the admission to the health centre, usually before physicians' appointments. A pharmacist will go through all medicines physicians have prescribed, over-the-counter medicines (OTC) and food supplements one by one to assess the actual medicine used by the patient. If a pharmacist identifies medication discrepancies between physician's prescriptions and patient's self-reported use of medicine during the medication reconciliation, she/he will find out the patients' reasons for adjusting the medication. Based on this process pharmacist formulates the updated medication list, including clinically appropriate over-the-counter medicines (OTC medicines) in the patient record system Apotti, where the physician will once more make sure that everything is in order. The pharmacist will advise the patient to clarify the possible misunderstandings or concerns toward medications and motivate the patient to use the medication as prescribed. The outcome of the discussion is documented.
The data will be analyzed by descriptive statistical analysis. The patients' reported reasons for medication discrepancies will be analyzed quantitatively, and central themes and subthemes will be classified. The risk ratio will be identified, i.e., the relative risk among the number of medicines and medication discrepancies. The investigators will compare the total number of patients' medicine, including non-prescription medicine, to medicine the patient is using differently as prescribed and calculate the possible comparative risk adjusting the medicine with the number of prescribed medicines. The investigators will also identify the high-risk medications for non-adherence. The investigators will analyze patients' need for information on medicines as the patient receives guidance and encouragement when the pharmacist identifies discrepancies. The data will be analyzed using IBM SPSS Statistics 26 software.
Tipo de estudio
Inscripción (Anticipado)
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Kirsi MK Kvarnström, MScPharm
- Número de teléfono: +358 40 656 9057
- Correo electrónico: kirsi.kvarnstrom@hus.fi
Copia de seguridad de contactos de estudio
- Nombre: Helena Liira, MD
- Correo electrónico: helena.liira@hus.fi
Ubicaciones de estudio
-
-
-
Vantaa, Finlandia, 01030
- Reclutamiento
- Vantaa healthcare and social services
-
Contacto:
- Helena Liira, MD
- Correo electrónico: helena.liira@hus.fi
-
Contacto:
- Kirsi MK Kvarnström, McPharm
- Número de teléfono: +358 40 656 9057
- Correo electrónico: kirsi.kvarnstrom@hus.fi
-
-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Método de muestreo
Población de estudio
Descripción
Inclusion Criteria:
- Patients with multimorbidity
- Patients with ≥5 prescription medicines
- Finnish speaking
- Living at home and managing daily life independently
- Willingness to take part and sign the informed consent
Exclusion Criteria:
- Patients not understand Finnish
- Diagnosed Alzheimer or another memory disorder
- Need help to manage daily life
- End of life care
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
Cohortes e Intervenciones
Grupo / Cohorte |
Intervención / Tratamiento |
---|---|
Patients with multimorbidity
Patients with multimorbidity who visit the public health centres in Vantaa, Southern Finland
|
A pharmacist will go through all medicines physicians have prescribed, over-the-counter medicines (OTC) and food supplements one by one to assess the actual medicine used by the patient.
If a pharmacist identifies medication discrepancies between physician's prescriptions and patient's self-reported use of medicine during the medication reconciliation, she/he will find out the patients' reasons for adjusting the medication.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Medication discrepancy
Periodo de tiempo: Through study completion, an average of 3 months
|
Comparison of actual use of medicines versus prescribed medicines
|
Through study completion, an average of 3 months
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
The groups of medicines
Periodo de tiempo: Through study completion, an average of 3 months
|
The medicines that are used differently as prescribes are classified in anatomical therapeutic chemical groups
|
Through study completion, an average of 3 months
|
The reason for non-adherence
Periodo de tiempo: Through study completion, an average of 3 months
|
Patient reported reasons for not taking medicines as prescribed
|
Through study completion, an average of 3 months
|
The effectiveness of medication information
Periodo de tiempo: Through study completion, an average of 3 months
|
Will the patient consider taking the medication as prescribed after the discussion with the pharmacist
|
Through study completion, an average of 3 months
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Director de estudio: Marja Airaksinen, PhD Pharm
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Anticipado)
Finalización del estudio (Anticipado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- HUS/1037/2020
- VD/4977/13.00.00/2020 (Otro identificador: The Institutional Review Board Vantaa)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
Ensayos clínicos sobre Medication reconciliation
-
University of North Carolina, Chapel HillMedical University of South Carolina; National Institute of Mental Health (NIMH) y otros colaboradoresTerminadoVIH/SIDA | Adherencia a la medicación | VIH | Comportamiento Sexual | Infecciones de transmisión sexual (no VIH ni hepatitis)Estados Unidos
-
Collabree AGUniversity Hospital, Basel, SwitzerlandReclutamientoHipertensión | Adherencia a la medicaciónSuiza
-
Anjali Raja BeharelleMediService AGInscripción por invitaciónHipertensión | Adherencia a la medicaciónSuiza
-
University of PittsburghRetiradoAdherencia a la medicación | Reacción adversa a la droga | Incumplimiento de la medicaciónEstados Unidos
-
AIDS Arms Inc.Terminado
-
University of Massachusetts, WorcesterNational Institute on Aging (NIA); University of Utah; Boston CollegeActivo, no reclutandoCuidados paliativos | Comunicación Interdisciplinaria | Cuidadores | Deprescripciones | Hospicios | Farmacia polivinílica | Uso excesivo de medicamentos recetadosEstados Unidos