Aged, Hospitalization, Patient Admission
Conditions
Keywords
collaborative pharmaceutical care
Brief summary
The primary objective of this study is to evaluate the impact of the implementation of collaborative pharmaceutical care on drug support at admission for patients 65 years of age and older. This is a cluster-randomized study with a stepped-wedge design. Clusters correspond to participating centers. A randomly selected center is crossed-over into the intervention every fifteen days after the start of inclusions.
Detailed description
The secondary objectives are to evaluate: A. The potential and observed clinical impact of the implementation of collaborative pharmaceutical care. B. The acceptance rate of pharmaceutical interventions during collaborative pharmaceutical care. C. Avoidable costs related to the consumption of care generated by the occurrence of serious adverse drug reactions. D. The satisfaction of health professionals concerning the transfer of information on the patient's drug therapy carried out as part of collaborative pharmaceutical care.
Interventions
OTHERCollaborative Pharmaceutical Care
The pharmacist performs collaborative pharmaceutical care in the ward: reconciliation of drug treatments and revision of drug prescriptions indicated on the admission drug prescription. He/she emits pharmaceutical interventions recorded on the standardized support provided by the French Society of Clinical Pharmacy. The pharmaceutical interventions are discussed during a collaborative interview.
Sponsors
Centre Hospitalier Universitaire de Nīmes
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The patient or his/her legal representative was informed about the study * The patient is admitted as an in-patient to one of the participating hospitals * The patient is available for 3 months of follow-up
Exclusion criteria
* The subject is participating in another drug study * The subject is under judicial protection * It is impossible to correctly inform the patient or his/her legal representative * The patient or his/her legal representative refuses to participate in the study * The expected life span of the patient is less than the required 3 months of follow-up * It is impossible to contact the patient after hospitalisation * Hospitalizatin for longer than 21 days
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of patients with at least one preventable medication error | Day 1 (medical prescription at hospital admission) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acceptance rate of pharmaceutical interventions during collaborative interview. | Day 1, hospital admission | — |
| Satisfaction questionnaire (for health care professionals) on the implementation of collaborative pharmaceutical care | End of study (expected at 195 days) | — |
| Avoided costs related to the occurrence of medication errors (criticality 3) | 90 days after hospital discharge (expected maximum of 21 days of hospitalization) | — |
| Length of hospital stay | hospital discharge (expected maximum of 21 days of hospitalization) | — |
| Number of patients at high risk for adverse drug events | Day 1 (medical prescription at hospital admission) | Potential clinical impact: number of patients at high risk for adverse drug events (Trivalle score calculated on the medical prescription at hospital admission) |
| Readmission rate for in-patient hospitalization | 30 days after hospital discharge (expected maximum of 21 days of hospitalization) | Clinical impact observed: readmission rate for in-patient hospitalization |
| Mortality rate | 30 days after hospital discharge (expected maximum of 21 days of hospitalization) | — |
| Preventable medication error rate | Day 1 (medical prescription at hospital admission) | Potential clinical impact: preventable medication error rate detected in the medical prescription at admission (MPA) according to the level of criticality 1, 2 or 3. This error rate is defined by the ratio of the number of avoidable errors to the number of unrevised lines in the MPA. |
Countries
France
Outcome results
None listed