Polypharmacy
Conditions
Brief summary
The purpose of this study is to examine the feasibility of providing a medication optimization program to improve patient health outcomes during the transition from hospital to home. This is because the period after hospital discharge is critical to long-term recovery, overall quality of life, and prevention of future hospitalizations.
Interventions
BEHAVIORALHomeMed
The HomeMed intervention is a multidisciplinary deprescribing intervention including home visits and team-based telehealth communication (optional). The components included in the HomeMed intervention include home medication review, medication education and provision of tools to assist the patients with medication administration, assessment of deprescribing targets by a trained geriatric clinical pharmacist, communication with the patient's treating primary care provider about deprescribing recommendation, deprescribing implementation (optional), and deprescribing monitoring (optional). Depending on the patient's treating primary care provider's decision on deprescribing and monitoring, the number of home visits ranges from a minimum of three to more with the entire duration of the intervention ranging from approximately 1 to 3 months.
Sponsors
National Institute on Aging (NIA)
University of Rochester
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patient Inclusion Criteria: * 65 years of age and older * currently hospitalized or having been hospitalized in the previous 2 weeks * having a discharge disposition of home with a referral to receive HHC services from URMHC, or currently receiving HHC services from URMHC * taking more than 10 regular medications daily * having a primary care provider who is in the URMC system * Ability to self-consent * English-speaking Patient
Exclusion criteria
* end-of-life prognosis in the following 6 months * currently receiving hospice care, end-of-life care, or palliative care * conditions that impact the receipt of the intervention, such as severe cognitive impairment that interferes with the subject's ability to communicate with interventionists; * substantial difficulties in hearing, vision, and verbal expression that disable the participant from communicating effectively while receiving the HomeMed intervention
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of participants undergoing deprescribing | 3 months | — |
| Percentage of intervention adherence indicators checked | 3 months | — |
| mean time spent on intervention | 3 months | — |
| number of participants who complete a post intervention survey about feasibility | 3 months | — |
| Percentage of patients who improve in ability to do things that are important before and after intervention | 3 months | — |
| Total number of medications used per participant | 3 months | — |
| Percentage of patients who report a reduction in medication burden | 3 months | Medication burden will be reported by phone or survey. |
| Percentage of participants who report a reduction in medication side effect | 3 months | Side effects will be collected by phone. |
Countries
United States
Outcome results
None listed