Intensive Care Unit, Medicines Reconciliation
Conditions
Brief summary
This study evaluates the effect of performing medicines reconciliation on patients admitted to an intensive care unit. Half of the patients will receive a medicines reconciliation at the intensive care unit. The other half will not. All included patients will receive medicines reconciliation after transfer to the ward.
Detailed description
Transfer of patients from one level of care to another is known to increase the risk of medication errors. Medication reconciliation is an accepted intervention to increase the knowledge on the patients medication use, thus reducing the risk of avoidable medication errors. For patients in the intensive care unit treatment of the imminent threat is obviously the most important. Nevertheless, knowledge about previous medications are important.
Interventions
OTHERMedication reconciliation at the ICU
Medication reconciliation performed according to Integrated Medicines Management model
OTHERMedication Reconciliation at the Ward
Medication reconciliation performed according to Integrated Medicines Management model
Sponsors
Hospital Pharmacy Enterprise, South Eastern Norway
University Hospital, Akershus
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Caregiver)
Masking description
The care provider performing medicines reconciliation at ward is semimasked. The masking might be broken if the patients tells if he/she has been interviewed earlier in the study
Intervention model description
The included patients are randomized to either intervention or control group. The intervention group receives medicines reconciliation at the intensive care unit. The control group receive standard pharmaceutical care, which now does not include medicines reconciliation. After the patients are transferred to care at the ward, medicines reconciliation is performed for all patients.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* belonging to the hospitals intake area * written informed concent by the patient or his/her next to kin
Exclusion criteria
* Patients without next to kin * Not Norwegian speaking, in need of a translator * medication reconciliation performed earlier * Patients with Guillain-Barre or Myasthenia Gravis, due to long expectancy of stay * Short life expectancy, decided in cooperation with the physician
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with at least one discrepancy between medications listed on hospital chart and medications used at home before hospital admittance | Medicines reconciliation is performed at randomisation and within 48 hours after transmission to the ward, assessed up to 28 days after randomisation | Medications listed on the medication chart were recorded on a predefined form, this included information on dosage form, strength, dosage and administration time for each drug. The pharmacist performed medicines reconciliation either by interviewing the patient or by gathering information from other sources as the patient's general practitioner, next-to-kin or if relevant nursing home. Any deviations between the information from the medication chart and information obtained during medicines reconciliation was defined as a discrepancy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Retrospective evaluation on the clinical relevance of the observed medical discrepancies | Retrospectively, based on the information gathered from the day of randomisation up until 28 days after randomisation | One clinical pharmacist and one senior geriatrician retrospectively asses the potential clinical relevance of the registered discrepancies. The expert panel use the following information for each patient when assessing the clinical relevance: medication list before and after reconciliation, age, gender, reason for hospitalisation, former and current diseases and the level of care before admission |
Countries
Norway
Contacts
Primary ContactSilje E Oernes, phD
Outcome results
None listed