A Study Evaluating the Use of Potential Predictors of Readmission in Hospitalized Medicine Patients
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|ClinicalTrials.gov Identifier: NCT03791541|
Recruitment Status : Withdrawn (Pilot study results not meaningful. Students researchers graduated.)
First Posted : January 2, 2019
Last Update Posted : September 24, 2020
|Condition or disease||Intervention/treatment||Phase|
|The Focus is to Test a Survey Predicting Readmissions Inpatient Internal Medicine Patients||Behavioral: Pharmacist services||Not Applicable|
Many patients are readmitted to the hospital shortly after discharge. Twenty percent of Medicare beneficiaries discharged were re-hospitalized within 30 days at a cost to Medicare estimated at $17.4 billion. This problem does not only affect the elderly. Medicaid enrollees aged 21-64 had 10.7% 30-day readmission rate. Identifying which patients are at highest risk is important for allocating resources to those high risk individuals.
Several studies have attempted to retrospectively identify medical conditions, medications, labs, and vitals associated with increased risk of readmission with different levels of success. Examples of these include the Charlson Comorbidity Index, LACE, and the Comorbidity Polypharmacy Score. Although not always developed for use in predicting readmissions, they have been subsequently associated with this.
While these indices examine objective data, it is thought that health beliefs, abilities, and behaviors can also affect the risk of readmissions. Health literacy in particular has been shown to be associated with 30 day readmissions after an acute myocardial infarction and in general medical patients. Low numeracy has been associated with increased risk of 30 day readmission in patients with acute heart failure.
Inpatient questionnaires are able to identify patients who are more likely than others to be readmitted. Additionally, objective qualities such as insurance status, comorbidities, and admissions within the past year are predictors of readmission. Due to the unique patient populations at different health systems, an institution-specific approach is necessary to analyze the specific factors contributing to readmission. Therefore, a survey will be used to gauge the most predictive factors of readmissions and ED visits, including objective and subjective sections. After further research and modification, the survey will potentially serve as a tool for clinicians to select the best approach to post-discharge care and follow-up.
This pilot will attempt to test a survey for predicting readmission through measurements of health literacy, numeracy, medication adherence, self-efficacy, and tolerance, and in conjunction with co-morbidity indices.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||0 participants|
|Intervention Model:||Parallel Assignment|
|Intervention Model Description:||targeted, cost-effective interventions based on results of surveys and other factors studied will be applied to study arm to see if re-admissions can be prevented|
|Masking Description:||Survey will be given to all participants|
|Official Title:||A Study Evaluating the Use of Potential Predictors of Readmission in Hospitalized Medicine Patients|
|Actual Study Start Date :||February 1, 2017|
|Actual Primary Completion Date :||December 1, 2017|
|Actual Study Completion Date :||February 27, 2018|
No Intervention: No Intervention
Only surveys will be done and re admissions tracked. No additional interventions based on survey results will be done.
Surveys plus increased outpatient pharmacist/pharmacy student services including but not limited to pre and post clinic visit phone calls, prescription counseling, and helping with adherence and compliance with medications. Increased services will be given based on survey results.
Behavioral: Pharmacist services
Additional pharmacist/pharmacy student follow-ups, counseling, and other services
- Number of readmissions after 1 month [ Time Frame: 30 days post-discharge ]Number of readmissions after 30 days post-discharge
- Number of readmissions after 2 months [ Time Frame: 60 days post-discharge ]Number of readmissions after 60 days post-discharge
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03791541
|United States, Illinois|
|University of Illinois at Chicago|
|Chicago, Illinois, United States, 60612|
|Principal Investigator:||Mat Thambi, PharmD||University of Illinois at Chicago|