Pharmacist Intervention to Reduce Post-Hospitalization Utilization
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores how a pharmacist-led program can reduce hospital visits after discharge by focusing on medication management. It aims to assist patients who have recently left the hospital and are taking multiple medications or have medications that could be risky if not managed well. The study compares usual care with the new pharmacist-led approach to determine which is more effective in preventing return trips to the hospital or emergency room. Suitable participants have recently been hospitalized, are over 55, and take ten or more medications or at least three high-risk drugs like insulin or blood thinners. As an unphased trial, this study offers an opportunity to contribute to innovative healthcare solutions that could improve medication management for many patients.
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 prior data suggests that this pharmacist-led intervention is safe?
Research has shown that pharmacist-led care during hospital discharge is generally safe. In one study, unexpected hospital visits occurred in 8.9% of patients in both the pharmacist-led and regular care groups, indicating that pharmacist involvement did not increase the likelihood of unexpected returns to the hospital. Another study found no major safety issues when pharmacists directly managed patients' medications.
These findings suggest that involving a pharmacist in care is safe. The pharmacist's role is to help manage medications more effectively, which can reduce risks associated with taking multiple or high-risk medications. Prospective trial participants can feel confident about the safety of this approach based on current evidence.12345Why are researchers excited about this trial?
Researchers are excited about the Pharmacist-Led Hospital Discharge Care Intervention because it offers a new approach to reducing post-hospitalization complications and re-admissions. Unlike standard care, which often involves general discharge instructions, this intervention provides a personalized touch by having pharmacists conduct medication reconciliation, regimen reviews, and offer adherence and literacy counseling. This direct involvement helps ensure patients understand their medications better, potentially leading to improved health outcomes and fewer return trips to the hospital.
What evidence suggests that this pharmacist-led intervention is effective for reducing post-hospitalization utilization?
Research has shown that involving a pharmacist can help reduce hospital readmissions. In this trial, participants in the Pharmacist Arm will receive a pharmacist-led intervention, including medication reconciliation, regimen review, and adherence and literacy assessment and counseling. One study found that a pharmacist-run clinic lowered the number of patients returning to the hospital within 30 days after discharge. Another study discovered that when pharmacists review and confirm medications with patients, it prevented readmissions due to medication mistakes. These findings suggest that pharmacists play a key role in managing medications after a hospital stay, helping to keep patients from needing to return to the hospital.26789
Who Is on the Research Team?
Joshua Pevnick
Principal Investigator
Associate Professor of Medicine
Are You a Good Fit for This Trial?
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
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Intervention
Pharmacist-led medication management intervention during hospital stay and post-discharge
Follow-up
Participants are monitored for post-discharge utilization, including readmissions and ED visits
Qualitative Study
Focus groups and interviews to understand implementation barriers and facilitators
Cost-effectiveness Study
Time-and-motion study to analyze pharmacist time and economic impact
What Are the Treatments Tested in This Trial?
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.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Pharmacist-Led Medication Reconciliation, Regimen Review, and Adherence and Literacy Assessment and Counseling
Patients in this study will receive usual care. Clinically-indicated services, including pharmacist services, may be provided to control group patients.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Cedars-Sinai Medical Center
Lead Sponsor
National Institute on Aging (NIA)
Collaborator
Citations
A post-discharge pharmacist clinic to reduce hospital ...
This study demonstrates that a hospital-based pharmacist-led post-discharge medication review clinic reduced 30-day hospital readmissions in ...
Pharmacist Intervention to Reduce Post-Hospitalization ...
This is a randomized trial testing a peri- and post-discharge pharmacist-led medication management intervention on post-discharge utilization.
The Pharmacist Discharge Care (PHARM-DC) study
One interrupted time series study found that inpatient pharmacy-led interventions can reduce hospital readmissions due to medication reconciliation errors [[13] ...
Effectiveness of pharmacist-led medication reconciliation ...
This pragmatic, prospective, controlled trial evaluated the effectiveness of routine pharmacist-led medication reconciliation compared to standard care.
The impact of hospital-based post-discharge pharmacist ...
A post-discharge clinic pharmacist may improve patient clinical outcomes such as hospital readmission and representation rates.
Effectiveness of pharmacist-led medication reconciliation on ...
Unplanned hospitalizations occurred in 8.9% of patients in both groups, while 5.2% (10/192) and 3.8% (6/158) of patients died in the ...
A stepped-wedge cluster randomised trial
The intervention saw a pharmacist aligned to a specialty, delivering collaborative services to patients: medication history taking, admission medication ...
8.
bmchealthservres.biomedcentral.com
bmchealthservres.biomedcentral.com/articles/10.1186/s12913-024-12024-6A systematic review of outcomes reported in studies to ...
This literature review aimed at collecting outcomes from studies investigating how to optimise medication use of patients following hospital discharge.
9.
shmabstracts.org
shmabstracts.org/abstract/pharm-dc-a-multicenter-randomized-controlled-trial-of-pharmacist-directed-transitional-care-to-reduce-post-hospitalization-utilization/PHARM-DC: A MULTICENTER RANDOMIZED ...
The primary outcome was unplanned all-hospital acute care utilization within 30 days of hospital discharge, including emergency department ...
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