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Completed

NCT Number: NCT02047448

Improving Medication Adherence Through a Transitional Care Pharmacy Practice Model

The purpose of this pilot study is to determine if medication adherence is improved by a transitional care pharmacy practice model designed to integrate hospital and community pharmacists in the care and education of patients with heart failure or COPD who are discharged from a community hospital to home. The hospital and community pharmacists will collaborate with each other, the patient, and other practitioners including the primary care physician, nurse, and case manager to prevent and correct medication-related problems and attempt to improve patient outcomes especially during the error-prone transition from hospital to home.

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Key information

Conditions

Pulmonary Disease, Chronic Obstructive Cardiovascular Diseases Chronic Disease Disease Attributes Heart Diseases Heart Failure Lung Diseases Lung Diseases, Obstructive Pathologic Processes Pathological Conditions, Signs and Symptoms Respiratory Tract Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2 / Phase 3

Primary location

Moses Taylor Hospital

Scranton, Pennsylvania, 18510, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • admitted to hospital with a primary or secondary diagnosis of heart failure or COPD
  • anticipated eventual discharge to home
  • agreeable to participate in monthly counseling sessions (if randomized to intervention group) from a participating community pharmacist

Exclusion criteria

  • presence of cognitive impairment or dementia that would significantly prevent effective patient education and counseling
  • non English-speaking
  • anticipated discharge to a long-term care or skilled nursing facility on a permanent basis
  • permanent long-term care facility residents
  • surgical patients
  • hospice patients
  • patients who die within 30 days of initial study hospitalization

Treatment and study plan

Pharmacist Counseling

Procedure

The hospital pharmacist will meet with the patient and complete medication reconciliation, assess the patient's understanding of the medications, and identify medication-related problems. The hospital pharmacist will complete a pharmacist discharge care plan and a copy will be sent to the participating community pharmacist. The patients will be scheduled for the first meeting with their community pharmacist within 1 week of hospital discharge. The community pharmacist will interview the patient about their general health and any current symptoms of heart failure or COPD, identify any additional medication-related problems, follow-up on any issues as described in the pharmacist discharge care plan, and provide patient education. The patients will then meet with their community pharmacist for counseling and patient education at monthly intervals for 6 months following hospital discharge.

Primary outcomes

  1. Medication Adherence

    Time frame: 6 months

    The primary endpoint will be medication adherence as measured by the Proportion of Days Covered (PDC) calculation. This is calculated by dividing the total days' supply dispensed by 180 days. Medications considered in this calculation will include those used for the treatment of heart failure or COPD and known to improve outcomes. The composite PDC will be an average of the individual PDC for each drug class.

Secondary outcomes

  1. Medication related problems

    Time frame: 6 months

    Actual or potential medication-related problems (MRP) that are identified by the hospital and participating community pharmacists will be categorized based on an MRP classification tool.

  2. Patient Satisfaction

    Time frame: 6 months

    The Care Transitions Measure (CTM-3) is a validated survey to assess the patient's satisfaction with the quality of transitional care during hospitalization and will be completed by the patient following hospital discharge. The patient's satisfaction with the services provided by the community pharmacies will be assessed with the Consumer Experience with Pharmacy Services survey (© Pharmacy Quality Alliance).

  3. Hospital readmissions or ED visits

    Time frame: 6 months

    Hospital readmissions are defined as an unplanned and overnight admission to the hospital

Sponsors and collaborators

Lead sponsor

Wilkes University

Other

Collaborators

  • Commonwealth Health
  • Community Pharmacy Foundation
  • Moses Taylor Hospital Foundation

Registry information

Important dates

Study start
2014
Primary completion
2017
Study completion
2017
First posted
Jan 28, 2014
Registry last updated
May 2, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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