Pharmacist-Led Televisits for Overmedication

Not currently recruiting at 3 trial locations

Overseen By Sheikh Hossain, MPH

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Dementia, lacks informed consent

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

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether a pharmacist managing medications through a home video call can improve medication adherence among veterans. It focuses on older veterans with at least two ongoing health issues who take five or more daily medications. The trial compares usual care with this new pharmacist-led approach of medication management via televisit to home. Veterans who have visited the VA for primary care in the past year, have multiple chronic conditions, and take several medications daily may qualify for this trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative care strategies that could enhance medication management for veterans.

Do I need to stop my current medications for the trial?

The trial does not specify if you need to stop your current medications. It focuses on managing and improving medication use, so it's likely you will continue your current regimen.

What prior data suggests that this pharmacist-led televisit intervention is safe for medication management?

Research has shown that pharmacist-assisted medication management through video calls at home is generally well-received. In one study, 81% of patients had at least one medication stopped, highlighting a focus on reducing unnecessary drugs. This approach aims to improve medication use and lower the risk of medication-related side effects.

Although specific details about side effects from this method are unavailable, similar studies have not reported any serious issues, suggesting it is safe. Since this method involves adjusting current medications rather than introducing new ones, the risk of new side effects is likely low. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about pharmacist-led televisits for medication management because this approach offers a personalized and convenient way to address overmedication. Unlike traditional in-person visits, these televisits allow pharmacists to connect with patients right at home, making it easier to review and adjust medications without the need for travel. This method can lead to more timely interventions and better adherence to medication plans, which is crucial for managing complex drug regimens. By leveraging technology, this approach aims to improve patient outcomes and reduce the risks associated with overmedication.

What evidence suggests that pharmacist-led televisits for medication management are effective for improving medication use in older Veterans?

This trial will compare usual care with a pharmacist-led intervention involving home televisits for medication management. Studies have shown that pharmacists managing medications through video calls at home can improve medication use. Research indicates that these video calls help reduce unnecessary medications, lowering the medication load for patients. One study found that participants took fewer medications on average, suggesting better management and possibly fewer side effects. Additionally, pharmacist assistance through telehealth is practical and can simplify complicated medication plans for older adults. These findings suggest that this method could improve medication use for older people with multiple long-term health issues. ^{1 3 4 6 7}

Who Is on the Research Team?

Lauren Rachel Moo, MD

Principal Investigator

VA Bedford HealthCare System, Bedford, MA

William W Hung, MD AB MPH

Principal Investigator

James J. Peters Veterans Affairs Medical Center

Are You a Good Fit for This Trial?

This trial is for older Veterans who've seen a VA primary care doctor in the past year, take at least 5 medications daily, and have at least 2 chronic conditions. It's not open to those unable to consent or with a dementia diagnosis.

Inclusion Criteria

Had at least 1 VA primary care visit within past year

I take 5 or more medications every day.

At least 2 chronic conditions

Exclusion Criteria

I have been diagnosed with dementia.

I am unable to understand or make decisions about my treatment.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive pharmacist-led medication management via home televisits

6 months

Regular televisits

Follow-up

Participants are monitored for medication appropriateness, self-efficacy, and adverse drug events

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Medication management via televisit to home

Trial Overview The study tests if managing medications through home televisits by pharmacists can improve medication use among Veterans with complex health needs. The focus is on reducing problems from taking many medicines.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

Receives pharmacist home televisit for medication management

Group II: Usual Care Active Control 1 Intervention

Usual care for outpatient medication management

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Published Research Related to This Trial

The pharmacist-led SMASH intervention significantly reduced potentially hazardous prescribing rates by 40.7% after 12 months in 43 general practices serving over 235,000 people, demonstrating its efficacy in improving medication safety.

While the intervention also led to a 22.0% reduction in inadequate blood-test monitoring at 24 weeks, this improvement was not sustained at 12 months, indicating a need for ongoing monitoring in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a pharmacist-led actionable audit and feedback intervention for improving medication safety in UK primary care: An interrupted time series analysis. Peek, N., Gude, WT., Keers, RN., et al.[2023]

Citations

1. researchprotocols.org researchprotocols.org/2025/1/e65141

Effect of Medication Management at Home via Pharmacist ... The objective of this study is to examine the effect of pharmacist-led medication through home televisits compared to usual care on appropriate medication use.

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38488757/

Pharmacist-led telehealth deprescribing for people living with ... The mean number of medications decreased by 0.6 (3.4) in the intervention and 0.2 (1.7) in the control, reflecting a non-clinically meaningful ...

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39908544/?utm_source=SimplePie&utm_medium=rss&utm_campaign=pubmed-2&utm_content=1pq-4TZ0w1pIimA2HHLJZYTkSjaU335U-aRSFRxJ31Blahz9sN&fc=20220524061305&ff=20250205190126&v=2.18.0.post9+e462414

Effect of Medication Management at Home via Pharmacist ... Objective: The objective of this study is to examine the effect of pharmacist-led medication through home televisits compared to usual care on ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT04340570

Study Details | Effect of Medication Management at Home Via ... In this study, the investigators aim to develop a protocol for pharmacy home televisits for medication management in older adults who have multiple chronic ...

5. deprescribingresearch.org deprescribingresearch.org/pharmacist-led-telehealth-deprescribing-for-people-living-with-dementia-and-polypharmacy-in-primary-care-a-pilot-study/

Pharmacist-led telehealth deprescribing for people living ... The study demonstrated that a pharmacist-led telehealth deprescribing intervention is feasible and may reduce medication burden and complexity ...

6. researchgate.net researchgate.net/publication/386120989_Effect_of_Medication_Management_at_Home_Via_Pharmacist-Led_Home_Televisits_Protocol_for_a_Randomized_Controlled_Trial_Preprint

Effect of Medication Management at Home Via Pharmacist ... appropriate medication use in older adults. Objective: The objective of this study is to examine the effect of pharmacist-led medication through home televisits ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11226386/

Pharmacist-Led Telehealth Deprescribing for People ... A pilot study of a pharmacist-led intervention to optimize medications with patient-care partner priorities, ran May 2021–22 at two health systems.