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
調査の概要
詳細な説明
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.
研究の種類
入学 (予想される)
連絡先と場所
研究連絡先
- 名前:Kirsi MK Kvarnström, MScPharm
- 電話番号:+358 40 656 9057
- メール:kirsi.kvarnstrom@hus.fi
研究連絡先のバックアップ
- 名前:Helena Liira, MD
- メール:helena.liira@hus.fi
研究場所
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Vantaa、フィンランド、01030
- 募集
- Vantaa healthcare and social services
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コンタクト:
- Helena Liira, MD
- メール:helena.liira@hus.fi
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コンタクト:
- Kirsi MK Kvarnström, McPharm
- 電話番号:+358 40 656 9057
- メール:kirsi.kvarnstrom@hus.fi
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
---|---|
Patients with multimorbidity
Patients with multimorbidity who visit the public health centres in Vantaa, Southern Finland
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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.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Medication discrepancy
時間枠:Through study completion, an average of 3 months
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Comparison of actual use of medicines versus prescribed medicines
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Through study completion, an average of 3 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
The groups of medicines
時間枠:Through study completion, an average of 3 months
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The medicines that are used differently as prescribes are classified in anatomical therapeutic chemical groups
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Through study completion, an average of 3 months
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The reason for non-adherence
時間枠:Through study completion, an average of 3 months
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Patient reported reasons for not taking medicines as prescribed
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Through study completion, an average of 3 months
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The effectiveness of medication information
時間枠:Through study completion, an average of 3 months
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Will the patient consider taking the medication as prescribed after the discussion with the pharmacist
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Through study completion, an average of 3 months
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協力者と研究者
捜査官
- スタディディレクター:Marja Airaksinen, PhD Pharm
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- HUS/1037/2020
- VD/4977/13.00.00/2020 (その他の識別子:The Institutional Review Board Vantaa)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
慢性疾患の臨床試験
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Adelphi Values LLCBlueprint Medicines Corporation完了肥満細胞性白血病 (MCL) | 攻撃的な全身性肥満細胞症 (ASM) | SM w Assoc Clonal Hema Non-mast Cell Lineage Disease (SM-AHNMD) | くすぶり全身性肥満細胞症 (SSM) | 無痛性全身性肥満細胞症 (ISM) ISM サブグループが完全に募集されましたアメリカ
Medication reconciliationの臨床試験
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University of North Carolina, Chapel HillMedical University of South Carolina; National Institute of Mental Health (NIMH); University of... と他の協力者完了HIV/エイズ | 服薬アドヒアランス | HIV | 性的行動 | 性感染症 (HIV や肝炎ではない)アメリカ
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Fondazione Poliambulanza Istituto Ospedalieroわからない
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Smiths Medical, ASD, Inc.完了