Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Impact of Pharmaceutical Medication Review, Medication Interview Before Discharge and Follow-up: A Randomized Controlled Trial
Brief Summary: Background

It is well known that the transfer of a patient from hospital to the general practitioner is related with mistakes in the medication of the patient. A report from 2006 measure the number of drug related admissions in Denmark to be 69.000 to 162.000 per year. To reduce these mistakes, more and better communication between the health professionals are suggested. Furthermore medication reviews made by pharmacist seems to reduce the number of drug related readmissions and other drug related issues, which can lead to an economic cost reduction.

Objective

The aim of this study is to investigate the impact of medication review and better communication between the health professionals after discharge of a patient from hospital to the general practitioner. The effect is measured as reducing the number of readmissions and number of visits at the emergency department 30 days and six month after inclusion of the patient.

Method

This study was estimated to include 1500 participants. The patients were randomized to one of three groups; usual care, basic intervention or extended intervention. The usual care received the normal care following the Danish standard procedure. The basic intervention had a medication review by a clinical pharmacist during admission.

The extended interventions group was similar to the basic intervention group plus follow-up with the patient, the general practitioner and if relevant the nursing home and pharmacy one week and six month after discharge by interview with the clinical pharmacist.


Options:
A: Inclusion Criteria:

1. Provision of informed consent by the patient or legal guardian/next-of-kin
2. Age ≥ 65 years
3. Arrival to hospital within previous 72 hours
4. Admitted as a general medical or surgical on call patient
5. Anticipated in-hospital stay of \> 48 hours,
6. ≥ 3 active (requiring current medication) chronic medical disorders

Exclusion Criteria:

1. Admitted under:

   * Geriatric Medicine
   * Clinical Pharmacology
   * Palliative Medicine
   * Clinical Oncology
   * Hematology
2. Intention of primary team at the time of subject admission to seek a Geriatric Medicine, Clinical Pharmacology or Palliative Medicine in-patient consultation
3. Life expectancy in the opinion of the admitting clinician of \< 3 months
4. Admission directly to an intensive care unit,
5. Admission with primary acute psychiatric illness (excluding delirium)
6. Admission with non-accidental overdose/self-harm
7. Anticipated immediate transfer to alternative non-participating clinical service/hospital
8. Clinical diagnosis of acute Liver failure
9. estimated Glomerular Filtration Rate \<10 ml/min per 1.73 m2
10. Solid organ transplant recipients
11. Patients with malignancy receiving systemic chemotherapy
12. Hospitalized for elective procedure
13. Patient was more than 24 hours in the Emergency Department under the care of a different team to that which finally is in charge of them
14. Patients who are actively participating in another clinical trial
B: Inclusion Criteria:

* Hospitalized at Vanderbilt University Medical Center
* Medicare-eligible
* Discharged from VUMC to a post acute care facility
* Has polypharmacy as defined by \> 5 medications
* Able to self-consent or has a proxy (surrogate)
* Speaks English (due to interview-based assessments)
* Primary home residence within one of 9 surrounding counties (due to home visit during follow-up phase)

Exclusion Criteria:

* Resides in long-term care
* Is currently on hospice or otherwise has a limited life expectancy (\< 6 months).
* Enrolled in a clinical drug trial
* Has Stage IV Cancer Diagnosis
* Incarcerated or homeless
* Unable to self-consent and does not have a surrogate
C: Inclusion Criteria:

* Usual medicine of five drugs or above
* Speak and understand Danish
* Admitted via the Acute Medicine Admission Ward
* Are able to give informed consent

Exclusion Criteria:

* Patients included in a similar study
* Declared terminal
* Suicidal
* In custody
* Isolated at the hospital
* Im- and/or expressive aphasia
* Severe dementia
D: Inclusion Criteria:

* Speaks either English or Spanish
* Willing to obtain all long-term prescriptions from one community pharmacy during the 90-day study period
* Diagnosed with at least one of the following conditions: high blood pressure, hyperlipidemia, heart failure, coronary artery disease, heart attack, stroke, transient ischemic attack, asthma, chronic obstructive pulmonary disease (COPD), diabetes, or receiving oral anticoagulation therapy
* Admitted to the general medicine, family medicine, cardiology, or orthopedics services hospital department

Exclusion Criteria:

* Does not have a working telephone
* Has a hearing impairment that does not allow the use of a telephone
* Enrolled in Iowa Care (i.e., individual has no community physician or community pharmacist following hospital discharge)
* Life expectancy estimated at less than 6 months at the time of study entry
* Dementia or cognitive impairment
* Severe psychiatric or psychosocial factors, including substance abuse, that may impair the desire or ability to complete all aspects of the study
* Admission to the psychiatric, surgery, or hematology/oncology services hospital department

Answer: C