None listed
Conditions
Brief summary
The study aims to evaluate the impact of clinical pharmacist medication review to improve appropriate prescribing as demonstrated by Medication Appropriateness Index (MAI) in comparison to standard care. This is a prospective randomized controlled trial, which will be conducted in Specialized Out-patient Clinic (SOPC) of the Department of Medicine in Pamela Youde Nethersole Eastern Hospital. For the intervention group, medication chart review and corresponding written recommendation will be performed by clinical pharmacists for all randomized patients. Medication chart review includes assessing the appropriateness of each of the regular medications based on laboratory findings, medication lists, consultation and discharge notes, procedures and test results. Face-to-face interview will be conducted with patients prior to the SOPC follow-up. Clinical pharmacists will assess drug use history, identify drug-related problems and provide drug therapy interventions through written pharmacist note to physicians during the SOPC follow-up, based on the medication chart review and the above pharmaceutical assessments. After the SOPC follow up, clinical pharmacist will provide education on drug-related problem identified before the visit, reinforce physician’s instruction, and encourage drug compliance using written patient educational leaflets. Phone follow follow-up will be conducted 1months after the SOPC visit. For patients randomized to the SOC group, they will attend the medical follow-up as usual and receive usual care All patients will be followed up for 1 months post-SOPC visit. Data collection will be conducted at baseline and1monthafter the SOPC visit. Primary outcome of the study is Medication Appropriateness Index (MAI)5, which will be measured at baseline (prior to physician visit), and at 1 month post SOPD follow-up.
Interventions
Patients with chronic disease have regular visit to their physician in the Specialist Out-patient Clinic (SOPC) for follow-up.
For the intervention group, clinical pharmacist with 5 years of clinical experience will perform medication chart review prior to the next SOPC follow-up, The review includes assessing the appropriateness of each of the regular medications based on laboratory findings, medication lists, consultation and discharge notes, procedures and test results. Face-to-face intervie
Patients with chronic disease have regular visit to their physician in the Specialist Out-patient Clinic (SOPC) for follow-up. For the intervention group, clinical pharmacist with 5 years of clinical experience will perform medication chart review prior to the next SOPC follow-up, The review includes assessing the appropriateness of each of the regular medications based on laboratory findings, medication lists, consultation and discharge notes, procedures and test results. Face-to-face interview (lasts for around 30-45 mins) will then be conducted with patients on the day prior to the SOPC follow-up. Clinical pharmacists will assess drug use history, identify drug-related problems and provide drug therapy interventions through written pharmacist note to physicians during the SOPC follow-up, based on the medication chart review and the above pharmaceutical assessments. Immediately after the SOPC follow up, clinical pharmacist will provide education (which lasts about 15 minutes) on drug-related problem identified before the visit, reinforce physician’s instruction, and encourage drug compliance using written patient educational leaflets. Phone follow follow-up will be conducted 1 month after the pharmacist intervention. Written patient education leaflets were published by the Central Pharmacy Office, Hong Kong Hospital Authority.
Sponsors
Pamela Youde Nethersole Eastern Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients are eligible for the study if they 1) attend medical follow up in Specialized Out-patient Clinic (SOPC) of the Department of Medicine, 2) are 65 years or older, 3) have hyper-polypharmacy (defined as 10 or more regular drugs and 4) agree to provide oral informed consent
Exclusion criteria
1) patients who are cognitively impaired (defined as a clinical diagnosis of dementia or mild cognitive impairment and/or not communicable and do not have care-givers, 2)patients who had received pharmacist medication review within six months prior to randomization.
Outcome results
None listed