Cancer, COPD, Heart Failure
Conditions
Keywords
Palliative Care
Brief summary
The transition of palliative care patients from inpatient to outpatient care is aimed to be improved through structured pharmaceutical discharge management by a trained pharmacist. This data will be compared with retrospective cases.
Detailed description
As part of a prospective observational study with a retrospective comparison group, a pharmacist should, on request, check the discharge medication planned by the primary care physicians before discharge and discuss it with the various colleagues providing (follow-up) care. In addition, the availability in the outpatient medicine cabinet and the possibility of prescribing by the responsible GPs (by telephone) should be checked in advance. In addition, longitudinal focus groups with relevant stakeholders are to be conducted to collect quantitative data as well as qualitative data on the views of those providing and receiving treatment. There will be cooperation with the Specialized Outpatient Palliative Care Service Muenster to ensure sufficient case numbers and a low rate of missing values through partial use of the standard care data from the Information System Palliative Care (ISPC) program they use.
Interventions
OTHERStructured pharmaceutical discharge management
These patients will receive structured pharmaceutical discharge management from inpatient to outpatient care.
Sponsors
University Hospital Munich
University Hospital Muenster
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All individual indications for general and specialised palliative care as part of routine clinical practice (e.g.): * advanced, malignant tumour disease * advanced, chronic obstructive pulmonary disease * Patients with advanced disease and limited life expectancy (approx. 12 months) Further care in the SOPC Muenster (prospective data) Sufficient understanding of the German language to be able to understand the information and consent form
Exclusion criteria
Impossibility of understanding the information and declaration of consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| (I) Drug-related problems | 12 months | (I) Number of drug-related problems at the time of discharge according to PCNE (comparison of prospective, actually proposed changes vs. hypothetical number and type of problems at the time of discharge in the retrospective comparison cohort) |
| (II) Drug-related problems | 12 months | (II) Type of drug-related problems at the time of discharge according to PCNE (comparison of prospective, actually proposed changes vs. hypothetical number and type of problems at the time of discharge in the retrospective comparison cohort) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| (I) Further parameters | 12 months | (I)Evaluation of further quantitative parameters from ISPC (SOPC) |
| (I) Post-discharge medication changes | 12 months | Change in the number of medications in outpatient follow-up care |
| (II) Medication changes | 12 months | (II) Type of medication changes suggested by pharmacists according to PCNE |
| (II) GP contact | 12 months | (II) Resulting changes to discharge medication following GP contact |
| (II) SOPC contact | 12 months | (II) Resulting changes to discharge medication following SOPC contact |
| Focus groups | 12 months | Satisfaction of inpatient physicians and those providing further treatment with forward-looking medication planning in 3 focus groups |
| (I) GP contact | 12 months | (I) Contact made with GPs for medication planning |
| (I) Medication changes | 12 months | (I) Number of medication changes suggested by pharmacists according to PCNE |
| Number of contacts | 12 months | Number of contacts made by patients/relatives with SOPC within 7 days of discharge |
| Number of readmissions / visits | 12 months | Number of readmissions and / or visits to the emergency department within 7 and 14 days after hospital discharge |
| Adoption rate | 12 months | Adoption rate by the primary care physicians of the pharmacist's proposed changes after PCNE (see primary endpoint) |
| (II) Post-discharge medication changes | 12 months | (II) Qualitative assessment of medication changes (classification of drug-related problems according to PCNE) |
| (II) Further parameters | 12 months | (II) Evaluation of further quantitative parameters from the clinical information system (UKM) |
| Symptom burden | 12 months | Change in patient symptom burden via Integrated Palliative Care Outcome. The total scores using the IPOS can range between 0 and 68 points. The higher the score, the more severe are the patient's symptoms. Scale after 3, 7 and 14 days compared to day 0 (discharge date) |
| (I) SOPC contact | 12 months | (I) Contact made with SOPC for medication planning and (II) resulting changes to discharge medication |
Countries
Germany
Contacts
Primary ContactChristoph Klaas, Dr. rer. nat.
Outcome results
None listed