- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00794560
Self-management of Low Molecular Weight Heparin Therapy
Self-management of Heparin Therapy - Drug Use Problems and Compliance With Self-injected Low Molecular Weight Heparin in Ambulatory Care
There is very little data available on compliance with self-injected low molecular weight heparins (LMWH), but what there is, definitely shows that compliance represents a significant problem. We therefore aim to a) record drug use problems of patients including compliance, b) develop a "SOP" for first instruction by a pharmacist and for subsequent pharmaceutical care and c) to compare intensive pharmaceutical care (intervention) vs. standard care (control) provided in the pharmacy to patients with a prescription for a LMWH as an outpatient treatment.
Hypothesis:
Intensive pharmaceutical care in ambulatory patients who self-inject low molecular weight heparins results in improved compliance, more safety and satisfaction as well as in fewer complications.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Patient recruitment in community pharmacies enables the testing of the feasibility of the interventions under daily-practice conditions and facilitates the recruitment of a larger number of patients.
Data collection:
- telephone interviews with structured questionnaires at the beginning and at the end of the therapy
- monitored self-injection in the study center or at patient's home (direct observation technique [DOT])
- compliance measurement: answers from patient interviews, comparing number of used syringes vs. number of prescribed syringes (analogue "pill count"), measuring residual volume in recycled syringes
- recording of the fine motor skills by the adapted "Disabilities of the Arm, Shoulder and Hand" questionnaire (DASH questionnaire)
Type d'étude
Inscription (Réel)
Phase
- Phase 4
Contacts et emplacements
Lieux d'étude
-
-
-
Basle, Suisse, CH-4031
- University Hospital of Basle, Switzerland
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Bruderholz, Suisse, CH-4101
- Kantonsspital Baselland, Switzerland
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Patients are recruited from orthopedic clinics, an emergency department and from community pharmacies with a prescription for a LMWH as an outpatient treatment.
- self-application of the LMWH
german / english speaking
-> clinical setting:
Dalteparin
-> daily life setting:
- all LMWH (ready-to-use syringes)
- control group: self-application or application by another person (family member, medical person, etc.)
Exclusion Criteria:
- patient's home far away from study center
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Soins de soutien
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Expérimental: clinical setting: intervention
Recruitment of patients in the hospital into the randomized intervention group. Intervention is done by a trained pharmacist/Doctor of Philosophy-student in the study center (a pharmacy) or at patient's bedside in the hospital. Intervention: patient education |
Possible, individualized interventions:
|
Aucune intervention: clinical setting: standard care
Recruitment of patients in the hospital into the randomized control group (standard care in community pharmacy)
|
|
Expérimental: daily life setting: intervention
Recruitment of patients in trained community pharmacies into the intervention group. Intervention is done by trained pharmacists. Intervention: patient education |
Possible, individualized interventions:
|
Aucune intervention: daily life setting: standard care
Recruitment of patients in community pharmacies into control group (standard care in community pharmacy)
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Drug Use Problems
Délai: during the individual drug therapy, an average of 18 days
|
During a home visit and at her/his individual injection time, each patient was monitored when self-administering an s.c.
injection (directly observed therapy, DOT).
Score minimum = -2.00;
score maximum = +2.00 for the objective estimation of the application quality.
Higher score values represent better outcomes.
|
during the individual drug therapy, an average of 18 days
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Compliance
Délai: at the end of the individual drug therapy, an average of 18 days
|
objectively determined by syringe count Therapy durations varied individually depending on the indication of the drug therapy (days to weeks).
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at the end of the individual drug therapy, an average of 18 days
|
Patient Satisfaction
Délai: at the end of the individual drug therapy, an average of 18 days
|
at the end of the individual drug therapy, an average of 18 days
|
Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Kurt E. Hersberger, Prof. PhD, Pharmaceutical Care Research Group, University of Basle, Switzerland
Publications et liens utiles
Publications générales
- Mengiardi S, Tsakiris DA, Molnar V, et al. Impact of Pharmaceutical Care on Self-Administration of Outpatient Low-Molecular-Weight Heparin Therapy. Pharmacology & Pharmacy 5: 372-385, 2014
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- NRA 630 00 23
- EKBB 95/07 (Autre identifiant: ethics committee)
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