Any medical condition Not Applicable
Conditions
Interventions
This project is an evaluation of a newly implemented service that was introduced in NHS acute hospital and surrounding Clinical Commissioning Group (CCG) in England in February 2019. The name of the s
Sponsors
University of Manchester
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: The study did not involve recruiting participants, the inclusion criteria for is for eligible patient records for retrospective screening by general practice pharmacists. ‘Safety’ impact study data: 1. Age of 18 years or above 2. Discharged from in-patient hospital stay at NHS acute hospital in England 3. Staying at least 24 hours in hospital 4. Patients are prescribed at least 1 regular medication 5. Patients must be registered to one of the 20 named general practices involved in the project, located within the study Clinical Commissioning Group 6. Patient discharged on new or recurrent Monitored Dosage System (MDS) during a predefined 6-month period before and after the TCAM service went live TCAM service utilisation ‘Activity’ data: 7. All patient discharged and referred via the TCAM service from March 2019 - February 2020
Exclusion criteria
Exclusion criteria: The study did not involve recruiting participants, the exclusion criteria are for patient records for retrospective screening stage by general practice-based pharmacists. 1. Patients discharged from an inpatient hospital stay from a hospital other than the proposed hospital 2. Patient stays less than 24 hours in NHS acute hospital in England 3. Discharged with no MDS 4. Patients who had a planned hospital admission including, e.g. dialysis, day-case surgery, chemotherapy or transfusion-related: as they are a specific group of patients which limits the generalisability of the data 5. Patients without a mediation reconciliation or equivalent data in the general practice computer system, to extract data from
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Measured before and after the introduction of the TCAM intervention: 1. Prevalence of medication discrepancies, and adverse drug events using data gathered pseudonymously from primary care electronic health records by general practice clinical pharmacists 2. Class of medications involved, patient gender and age group involved associated with medication discrepancies measured using data from health records 3. Presence, preventability (ADEs) and potential/actual severity of identified medication discrepancies and adverse drug events using review by an expert panel 4. Factors associated with increased risk of medication discrepancies and adverse drug events measured using data from health records: 4.1. Patient factors: patients age, gender, hospital discharge diagnosis 4.2. Medication factors: medication group, medicine dose, and medicine formulation 4.3. Service factors: time to complete medication reconciliation 5. Time to identification of discrepancies using medication reconciliation (or equivalent) entry data gathered pseudonymously from electronic health records by general practice clinical pharmacists 6. Number of referrals, nature of the referrals and outcome of the referrals (i.e. activity in community pharmacy post-hospital discharge) including accepted, completed and rejected referral rates, and any reasons for rejections by community pharmacy using a mixed-method approach to analyse anonymised patient referral data via PharmOutcomes™ | — |
Secondary
| Measure | Time frame |
|---|---|
| There are no secondary outcome measures | — |
Countries
England, United Kingdom
Outcome results
None listed