Medication Adherence, Medication Administered in Error
Conditions
Keywords
medication discrepancy, primary care, transition of care
Brief summary
This study evaluates the the effectiveness of pre-consultation Medication Reconciliation Service in reducing unintentional medication discrepancies among patients who discharged from hospital to primary care.
Detailed description
Medication discrepancies during care transition were common. Many factors contribute to the risk of medication discrepancies. Despite medication reconciliation service being practiced in the hospital setting, there was limited knowledge on its effectiveness in the primary care setting. This study aims to evaluate the effectiveness of a pre-consultation medication reconciliation service in reducing medication discrepancies in patients who transit from hospital to primary care. Adult patients who made their first visit to the polyclinics following a recent hospital discharge and were prescribed with 5 or more chronic medications were randomised to 2 groups. Pre-consultation medication reconciliation by a pharmacist was carried out for the intervention group. Outcome was assessed by a different pharmacist who was blinded to the randomised allocation. The control group underwent usual care without a pre-consultation medication reconciliation.
Interventions
OTHERPre-Consultation Medication Reconciliation
Medication reconciliation service to be done for participants randomised to the intervention group
Sponsors
National Healthcare Group, Singapore
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Age 21 years and older 2. Patient or primary caregiver was able to provide informed consent 3. Patient or primary caregiver was English, Mandarin or Malay speaking 4. Patient was able to self-administer medications, or accompanied by a caregiver who assisted in administering medications 5. Patient was prescribed 5 or more chronic medications 6. The day of the study visit was the first follow-up visit in National Healthcare Group Polyclinics for chronic disease management after recent discharge from a local public hospital
Exclusion criteria
1. Residents of nursing home 2. The day of the study visit was for acute illness consult 3. Unwilling to consent to a 30-day follow-up phone call.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Unintentional medication discrepancies | 1 day | Any unintentional medication discrepancies after doctor's consultation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Types of medication discrepancies | 1 day | Type of medication discrepancies, by a validated instrument by Claeys et al, (Claeys C, Neve J, Tulkens PM, Spinewine A. Content Validity and Inter-Rater Reliability of an Instrument to Characterize Unintentional Medication Discrepancies.Drugs & Aging. 2012 July; 29(7): 577-91.) |
| Causes of medication discrepancies | 1 day | Causes of medication discrepancies, by a validated instrument by Claeys et al, (Claeys C, Neve J, Tulkens PM, Spinewine A. Content Validity and Inter-Rater Reliability of an Instrument to Characterize Unintentional Medication Discrepancies.Drugs & Aging. 2012 July; 29(7): 577-91.) |
| Medication adherence | 30 days | Medication adherence by The 8-item Morisky Medication Adherence Scale |
| 30-day re-hospitalisation | 30 days | rate of re-hospitalisation 30 days after the study visit |
Outcome results
None listed