Any Event Leading to Hospitalisation
Conditions
Keywords
adherence, electronic monitoring, primary care, community pharmacy, multidrug blister pack, pill box
Brief summary
The purpose of this study is to determine the benefit of patients using a multidrug blister packs after discharged from an university hospital to their homes.
Detailed description
Typical adherence rates for oral prescription medications are approximately 50-76%. Insufficient adherence causes an increase in morbidity, mortality, and costs, and decreases quality of life of patients. Multidrug blister packs are recommended to improve adherence and are widely used in Switzerland. However, evidence is poor and patient-relevant endpoints are seldom measured. This study was designed to compare patient-relevant outcomes in patients with medication repackaged in multidrug blister packs versus patients with medication dispensed in commercially available packages. Adherence of the intervention group will be monitored electronically and feedback will be given to the patients. The intervention will take place in a study pharmacy. Follow-up visits will take place at the study pharmacy at 3, 6, and 12 months for all patients. Study duration will be 12 months.
Interventions
DEVICEElectronic multidrug blister pack
At hospital discharge, patients will get their prescribed drugs repackaged in an electronic multidrug blister pack with 7x4 cavities. The electronic film affixed on the rear side measures the date and time when a loop is broken, i.e. when a cavity is emptied. Patients will get feedback on their adherence profiles at the community pharmacy.
Sponsors
Kurt Hersberger
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age over 18 years * Prescription of 4 or more different oral solid drugs * Capable to understand german (verbally and written) * Capable to give informed consent * Insured by a Swiss health insurance * Manages his/her pharmacotherapy without external support * Obtains his/her medication from a community pharmacy * Accepts to use an electronic multidrug blister pack * Place of domicile in Basel-Stadt or Basel-Land
Exclusion criteria
* Pregnancy * \> 2 drugs that cannot be packed into a multidrug blister pack (e.g. fluids) * Dementia, or evaluated as cognitively impaired by the responsible nurse * Transplanted patient * Anticoagulation with oral vitamin K antagonists * Has already used a multidrug blister pack of Pharmis or a Medifilm® single dose system * is visually impaired (blind) * cannot push drugs through a blister * refuses to allow contact to his/her regular pharmacy and GP * is referred to a nursing home or to rehabilitation or another hospital at discharge * is included in other clinical trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to rehospitalisation + time to major therapy adjustment | 12 months | The outcome measure will be assessed at 3, 6, and 12 months. |
| Medication Possession Ratio | 12 months | MPR will be assessed at 3, 6, and 12 months. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Timing and taking adherence according to the electronic monitoring system and through patient self report | 12 months | Electronic monitoring will be continuous over 12 months. Patient self report will be assessed at 3, 6, and 12 months. |
| Quality of life | 12 months | Quality of life will be assessed at 3, 6, and 12 months. |
| Patient satisfaction | 12 months | — |
Countries
Switzerland
Outcome results
None listed