Pharmacist Intervention to Reduce Post-Hospitalization Utilization

Recruiting at 1 trial location

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Cedars-Sinai Medical Center

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

6478 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial tests a pharmacist-led program to help older adults manage their medications after leaving the hospital. It aims to reduce readmissions and emergency visits by ensuring patients take their medicines correctly and safely.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, since the study focuses on managing medications after hospital discharge, it's likely that you will continue taking your current medications with guidance from a pharmacist.

What data supports the effectiveness of the treatment Pharmacist-led Hospital Discharge Care Intervention?

Research shows that pharmacist interventions during hospital discharge can improve patient satisfaction and medication adherence (taking medicine as prescribed). Although the rate of hospital reutilization (return visits) was similar between groups, pharmacist-led care can help prevent medication-related problems and improve overall patient care. ^{1 2 3 4 5}

Is pharmacist-led discharge care safe for patients?

Pharmacist-led discharge care interventions are generally safe and can help improve medication adherence and patient satisfaction, reducing the risk of medication-related problems after leaving the hospital. ^{1 2 5 6 7}

How is the Pharmacist-led Hospital Discharge Care Intervention treatment different from other treatments?

This treatment is unique because it involves pharmacists actively participating in the hospital discharge process, providing follow-up care and counseling to patients, which can help reduce hospital readmissions and improve medication adherence. Unlike standard treatments that may not include such personalized pharmacist involvement, this approach focuses on ensuring patients understand their medications and care plan after leaving the hospital. ^{1 3 4 8 9}

Research Team

Joshua Pevnick

Principal Investigator

Associate Professor of Medicine

Eligibility Criteria

This trial is for older adults (55+) who are at risk of medication issues after leaving the hospital. They must be taking more than 10 prescription meds or over three high-risk meds like blood thinners or diabetes drugs. It's not for those without stable housing, discharged out-of-state, in hospice care, previously enrolled, under certain specialists' care, or with COVID-19.

Inclusion Criteria

This criterion does not apply to me.

I am taking 10 or more prescription medications.

I am currently admitted to a hospital ward.

Exclusion Criteria

Expected AMA or left hospital against medical advice (AMA)

I will get medication management from a pharmacist after leaving the hospital.

Expected discharge to another state, acute care facility, psychiatric facility, or locked facility (including locked skilled nursing facility, jail, or prison)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Intervention

Pharmacist-led medication management intervention during hospital stay and post-discharge

Hospital stay + 30 days post-discharge

In-hospital visits and post-discharge phone call

Follow-up

Participants are monitored for post-discharge utilization, including readmissions and ED visits

30 days

Qualitative Study

Focus groups and interviews to understand implementation barriers and facilitators

3 days per site visit

Cost-effectiveness Study

Time-and-motion study to analyze pharmacist time and economic impact

Treatment Details

Interventions

• Pharmacist-led Hospital Discharge Care Intervention

Trial Overview The study tests a pharmacist-led program to manage medications when patients leave the hospital. The goal is to see if this helps reduce emergency visits and readmissions within 30 days post-discharge. Patients are randomly chosen to either get this extra pharmacy help or usual care.

Participant Groups

Group I: Pharmacist Arm Experimental Treatment 1 Intervention

Pharmacist-Led Medication Reconciliation, Regimen Review, and Adherence and Literacy Assessment and Counseling

Group II: Usual Care Active Control 1 Intervention

Patients in this study will receive usual care. Clinically-indicated services, including pharmacist services, may be provided to control group patients.

Who Is Running the Clinical Trial?

Cedars-Sinai Medical Center

Lead Sponsor

Trials

523

Recruited

165,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

References

1. United States pubmed.ncbi.nlm.nih.gov

Evaluating provider acceptance of pharmacist interventions in the Discharge Companion Program and its association with readmission reduction. [2021]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Impact of pharmacist discharge medication therapy counseling and disease state education: Pharmacist Assisting at Routine Medical Discharge (project PhARMD). [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Impact of a transition-of-care pharmacist during hospital discharge. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Using medication containers during pharmacist transitional care visits and impact on medication discrepancies identified and hospital readmission risk. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

The Pharmacist Discharge Care (PHARM-DC) study: A multicenter RCT of pharmacist-directed transitional care to reduce post-hospitalization utilization. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Impact of a pharmacy-based transitional care program on hospital readmissions. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Rationale and design of the Pharmacist Intervention for Low Literacy in Cardiovascular Disease (PILL-CVD) study. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Pharmacist calls to older adults with cognitive difficulties after discharge in a Tertiary Veterans Administration Medical Center: a quality improvement program. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Impact of discharge medication counseling in the cardiology unit of a tertiary hospital in Brazil: A randomized controlled trial. [2022]