Clinical Pharmacist-Led Bundled Care Model on Preventable Polypharmacy and Cost Avoidance
Impact of a Clinical Pharmacist-Led Bundled Care Model on Preventable Polypharmacy and Cost Avoidance Among Hospitalized Adults in Oman: A Prospective Randomized Controlled Study
This study aims to evaluate whether a clinical pharmacist-led bundled care model can improve medication use and health outcomes in hospitalized adult patients with preventable polypharmacy. Preventable polypharmacy refers to the use of multiple medications when some may no longer be necessary, may be inappropriate, or may increase the risk of medication-related harm.
Participants will be randomly assigned to receive either the pharmacist-led bundled care intervention in addition to usual hospital care or usual hospital care alone. The intervention includes comprehensive medication reconciliation, assessment of medication appropriateness, identification of potentially inappropriate medications, individualized deprescribing recommendations when appropriate, patient and caregiver education, discharge medication reconciliation, and follow-up after hospital discharge.
The study will compare important clinical outcomes between the two groups, including hospital readmissions, emergency department visits, adverse drug events, medication appropriateness, quality of prescribing, and healthcare costs. The findings will help determine whether integrating a clinical pharmacist-led bundled care model into routine hospital practice can improve patient safety, optimize medication use, and reduce unnecessary healthcare utilization.
연구 개요
상태
정황
연구 유형
등록 (추정된)
단계
- 해당 없음
참여기준
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
Inclusion Criteria:
- Adults aged 18 years or older.
- Admitted under an adult medical specialty at one of the participating hospitals.
- Receiving five or more regular medications at the time of hospital admission.
- Expected hospital stay of at least 48 hours.
- Able and willing to provide written informed consent.
Exclusion Criteria:
- Admission under obstetric, pediatric, or psychiatric services.
- Admission to an intensive care unit.
- Terminal illness with an expected survival of less than three months.
- Unable to provide informed consent and without an available legal representative.
- Declines participation in the study.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 건강 서비스 연구
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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활성 비교기: Control Arm: Usual Care
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Participants randomized to the control arm will receive usual hospital care provided according to the standard practices of the participating institutions.
This includes routine medical and nursing care, medication prescribing and review by the treating healthcare team, and standard discharge processes.
No structured clinical pharmacist-led bundled care intervention, standardized comprehensive medication review, protocol-driven deprescribing, or post-discharge pharmacist follow-up will be provided as part of the study.
Clinical pharmacy services that are routinely available at the participating hospitals may be provided as part of usual care but will not follow the standardized intervention protocol.
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활성 비교기: Intervention Arm: Clinical Pharmacist-Led Bundled Care
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Participants randomized to the intervention arm will receive a structured clinical pharmacist-led bundled care model in addition to usual hospital care.
The intervention includes medication reconciliation at admission, comprehensive medication review, identification and resolution of medication-related problems, assessment of medication appropriateness using validated tools, deprescribing of potentially inappropriate medications when clinically indicated, dose optimization, evaluation of drug-drug interactions and medication safety, individualized pharmaceutical care planning, participation in multidisciplinary care with recommendations to the treating team, patient and caregiver medication counseling, discharge medication reconciliation, provision of an updated medication list, and post-discharge follow-up to reinforce medication adherence, identify medication-related problems, and optimize ongoing therapy.
All interventions will be delivered according to a standardized study protocol
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Total Healthcare Cost Avoidance per Participant
기간: 90 days after hospital discharge
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The difference between the intervention and control groups in total healthcare cost avoidance per participant associated with the clinical pharmacist-led bundled care model. Total cost avoidance will include direct medication and investigation cost reductions and indirect costs avoided through prevention of adverse drug events, reduced hospital length of stay, and reductions in unplanned hospital readmissions and emergency department visits. Cost avoidance will be calculated using institutional healthcare utilization and costing data and standardized cost-avoidance values for accepted pharmacist interventions. |
90 days after hospital discharge
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Prevalence of Preventable Polypharmacy at Hospital Discharge
기간: through study completion, an average of 1 week during admission
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The proportion of participants with one or more unnecessary, inappropriate, duplicative, or potentially harmful medications at hospital discharge, compared between the pharmacist-led bundled care group and the usual-care group.
Preventable polypharmacy will be assessed using predefined clinical criteria, comprehensive medication review, and validated medication-appropriateness tools.
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through study completion, an average of 1 week during admission
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Number of Medications Deprescribed per Participant
기간: through study completion, an average of 1 week during admission
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The number of unnecessary, inappropriate, duplicative, or potentially harmful medications discontinued following medication review.
Only deprescribing recommendations accepted and implemented by the treating medical team will be counted.
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through study completion, an average of 1 week during admission
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Incidence of Adverse Drug Events
기간: From hospital admission through 90 days after discharge
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During the index hospitalization and at 90 days after hospital discharge
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From hospital admission through 90 days after discharge
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All-Cause Hospital Readmission
기간: 30 days and 90 days after hospital discharge
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The proportion of participants with at least one unplanned all-cause hospital readmission following discharge, compared between the intervention and control groups.
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30 days and 90 days after hospital discharge
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기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Number of Medication-Related Problems Identified and Resolved
기간: through study completion, an average of 1 week during admission
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The number and type of medication-related problems identified by clinical pharmacists and the proportion resolved following acceptance and implementation of pharmacist recommendations.
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through study completion, an average of 1 week during admission
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공동 작업자 및 조사자
연구 기록 날짜
연구 주요 날짜
연구 시작 (추정된)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
- 188/2026
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
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