the Pharmacy Intervention Team Hospital-based (PITH) for People Study: Effect on Clinical and Economic Outcomes
The purpose of this study is to determine whether a hospital pharmacy team (pharmacy technicians and pharmacists) together with (recently admitted) patients are able to diminish the number of drug related problems including adverse drug events, made before, during and after admissions resulting in reductions of re-hospitalizations and costs.
Adverse Drug Reaction
Medication Administered in Error
Other: integrated medicines management
|Study Design:||Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
|Official Title:||The Effect of Patient Centered Medication Reconciliation, Medication Review and Discharge Counseling With Information Transfer in Hospitalized Patients on Clinical and Economic Parameters: a Multicentre, Before-after Study.|
- number of rehospitalizations [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]this objective will be measured in three different ways: by National data extraction from hospitals (including ED visits and re-hospitalizations) as well as supporting insurance company, and by patient diaries.
- number of rehospitalizations [ Time Frame: 14 days ] [ Designated as safety issue: Yes ]this objective will be measured in three different ways: by National data extraction from hospitals (including ED visits and re-hospitalizations) as well as supporting insurance company, and by patient diaries.
- number of rehospitalizations [ Time Frame: 42 days ] [ Designated as safety issue: Yes ]this objective will be measured in three different ways: by National data extraction from hospitals (including ED visits and re-hospitalizations) as well as supporting insurance company, and by patient diaries.
- numbers of ADEs [ Time Frame: 14 days after discharge ] [ Designated as safety issue: Yes ]PAtients are contacted by phone. Possible ADEs are scored using a trigger list, developed by Schnipper et al, containing possible red flags on symptoms that might include alarming adverse drug reactions or deterioration of the clinical situation. In order to assess the presence of a preventable ADE, an independent team of an experienced pharmacist and a physician assesses ADEs.
- numbers of DRPs [ Time Frame: on admission at discharge ] [ Designated as safety issue: Yes ]For each patient potential DRPs will be explored with a list of combined triggers based on explicit criteria extracted from literature e.g. Morimoto et al., Start and STOPP criteria and Acove in combination with a protocol based on the Harm- Wrestling report developed by the Royal Dutch Pharmaceutical Society (KNMP) in conjunction with the Healthcare Department, is used.
- cost per prevented re-hospitalization [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- general health care use [ Time Frame: 6 months ] [ Designated as safety issue: No ]cost like general practitioner visits, emergency department visits are extracted from insurance company data.
|Study Start Date:||January 2013|
|Estimated Study Completion Date:||December 2014|
|Estimated Primary Completion Date:||December 2013 (Final data collection date for primary outcome measure)|
Placebo Comparator: usual care
During admission patients receive standard, non - ward based, pharmaceutical care from a pharmacy team in taking responsibility for the appropriate, safe and cost-effective use of medication from a central hospital pharmacy. The pharmaceutical care consist of daily screening of generated alerts by the Computerized physician order entry (CPOE) system and consultation by phone. Dependent on the local situation the current medication reconciliation process is being performed by nursing and/or medical staff either protocolised or not.
Active Comparator: integrated medicines management
integrated medicines management consists of
Other: integrated medicines management
PITH includes the following interventions:
A) MR on admission to obtain an up-to-date medication list, B) Intermediate medication review during hospitalization C) MR at discharge to maintain an up-to-date medication overview, counseling of the patient at hospital discharge and preparation of the patient to manage their medication at home., Written material is provided for oral support, which includes an overview of the current medication, a summary of potentially important side effects, advices on medication use and hospital pharmacy contact information in order to answer any possible questions, D) Information transfer to GP/community pharmacist at discharge
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|Contact: CCM stuijt, PharmDemail@example.com|
|Almere, Netherlands, 1315 RA|
|Contact: HT Ensing, PharmD 31365454378 firstname.lastname@example.org|
|Contact: M Zegstroo, pharm techn. 31368688537 email@example.com|
|Principal Investigator: Rik Ensing, PharmD|
|Sint Lucas Andreas Ziekenhuis||Not yet recruiting|
|Contact: MJA Janssen, PharmD, PhD 0031205108911 ext 319 firstname.lastname@example.org|
|Principal Investigator: MJA Janssen, PharmD, PhD|
|Medisch Centrum Leeuwarden||Not yet recruiting|
|Leeuwarden, Netherlands, 8901BR|
|Contact: A Jansen, PharmD 31582861295 email@example.com|
|Principal Investigator: Anita Jansen, PharmD|
|University Medical Centre||Recruiting|
|Contact: A de Roos A.M.deRoosfirstname.lastname@example.org|
|Principal Investigator: S v Lieshout-Bocxe, PharmD|
|Study Director:||Bart van den Bemt, PharmD, PhD||Maartenskliniek|
|Principal Investigator:||Fatma Karapinar, PharmD||LucasAndreas hospital|