Asthma, COPD
Conditions
Keywords
inhaler, pharmacy
Brief summary
The goal of this study is to assess the impact of pharmacist-led benefits investigations and application of clinical practice guidelines on patient access to inhalers and time to hospital readmission or Emergency Department (ED) visit.
Interventions
OTHERBenefits investigation
The study pharmacist will review the prescribed inhaler for 1) insurance coverage and 2) clinical appropriateness. The pharmacist will conduct a benefits investigation at time of hospital admission. The benefits investigation involves running test claims for inhalers to determine the most cost-effective inhaler for the patient's insurance plan. The study pharmacist will utilize clinical practice guidelines to assess appropriateness of the prescribed inhaler. Based on this review, the study pharmacist will submit a pharmacy consult to the inpatient pharmacist on the patient's healthcare team who will pend the inhaler orders (changing the patient's prescribed inhaler, if necessary) for the prescriber to send to the Meds to Beds discharge pharmacy. The Meds to Beds pharmacist will counsel the patient on inhaler use techniques prior to discharge.
Sponsors
Vanderbilt University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patient admitted to Vanderbilt University Medical Center (VUMC) (excluding surgery services) * on a long acting inhaler or prescribed a long acting inhaler during admission.
Exclusion criteria
* Diagnosis of cystic fibrosis * Diagnosis of graft versus host disease (GVHD) * no medication insurance * discharge to any post-acute care facility or inpatient hospice * death during hospitalization
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to either hospital readmission or ER visit | 6 months | Combined time (days) to either hospital readmission or emergency department visit after hospitalization (all outcomes measured at 6 months post-discharge with a 3 month interim analysis) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of ED visit | 6 months | number of ED visits 6 months post-discharge |
| frequency of hospital readmissions | 6 months | number of hospital readmission 6 months post-discharge |
| time to 1st ED visit (days) | 6 months | time until the first ED visit post-discharge |
| time to 1st readmission (days) | 6 months | time until the first readmission post-discharge |
| frequency of prescribed inhaler at discharge | 6 months | number of times the recommended inhaler was prescribed at discharge |
| frequency of short course prescription of oral steroid | 6 months | number of oral steroid prescriptions in the 6 months post-discharge |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORKristina Niehoff, PharmD
Vanderbilt University Medical Center
Outcome results
None listed