nctId: NCT06374277 id: 23-09339-IAA briefTitle: Pharmacy-led Transitions of Care Intervention to Improve Medication Adherence acronym: MedAAAction overallStatus: RECRUITING date: 2024-04-06 date: 2027-09-30 date: 2028-01-31 date: 2024-04-18 date: 2024-04-25 name: University of Tennessee class: OTHER name: Sponsor GmbH briefSummary: Socioeconomically disadvantaged populations with multiple chronic conditions have high rates of nonadherence to essential chronic disease medications after hospital discharge. Medication nonadherence after hospital discharge is significantly associated with increased mortality and higher rates of readmissions and costs among these patients. Major patient-reported barriers to essential medication use after hospital discharge among low-income individuals are related to social determinants of health (SDOH) and include: 1) financial barriers , 2) transportation barriers, and 3) system-level barriers. Although, medication therapy management services are important during care transitions, these services have not proven effective in improving medication adherence after hospital discharge, highlighting a critical need for innovative interventions. The Medication Affordability, Accessibility, and Availability in Care Transitions (Med AAAction) Study will test the effectiveness of a pharmacy-led care transitions intervention versus usual care through a pragmatic randomized controlled trial of 388 Medicaid and uninsured hospital in-patients with MCC from three large healthcare systems in Tennessee. The intervention will involve: 1) medications with zero copay, 2) bedside delivery then home delivery of medications, and 3) care coordination provided by certified pharmacy technicians/health coaches to assist with medication access, medication reconciliation, and rapid and ongoing primary care follow-up. We will examine the impact of the intervention during 12 months on 1) medication adherence (primary outcome) and 2) rapid primary care follow-up, 30-day readmissions, hospitalizations and emergency department visits, and costs. We will conduct key informant interviews to understand patient experience with the acre received during and after care transitions. By examining effectiveness of the intervention on outcomes including medication adherence, health care utilization, costs, and patient experience, this study will provide valuable results to health systems, payers, and policymakers to assist in future implementation and sustainability of the intervention for socioeconomically disadvantaged populations. conditions: Diabetes conditions: Hypertension conditions: High Cholesterol/Hyperlipidemia conditions: Coronary Artery Disease conditions: Congestive Heart Failure conditions: Chronic Lung Disease conditions: Chronic Kidney Diseases conditions: Arrythmia conditions: Stroke conditions: Depression conditions: Anxiety conditions: Pulmonary Embolism conditions: Heart Attack studyType: INTERVENTIONAL phases: NA allocation: RANDOMIZED interventionModel: PARALLEL interventionModelDescription: Eligible patients who sign consent forms and complete baseline surveys will be randomized to the Med AAAction intervention group or the usual care in a 1:1 ratio, stratified by health system. The participants will be enrolled before hospital discharge. The Med AAAction intervention will include the following components: 1) medications with zero copay, 2) bedside delivery and subsequent home delivery of medications, and 3) care coordination provided by certified pharmacy technicians/health coaches to assist with medication access, medication reconciliation, and rapid and ongoing primary care follow-up after hospital discharge. The intervention will be provided for one-year. primaryPurpose: HEALTH_SERVICES_RESEARCH masking: NONE count: 388 type: ESTIMATED name: Med AAAction intervention measure: Adherence to chronic disease medications measure: Health care utilization measure: Cost measure: Qualitative Evaluation sex: ALL minimumAge: 18 Years stdAges: ADULT stdAges: OLDER_ADULT facility: University of Tennessee Medical Center status: NOT_YET_RECRUITING city: Knoxville state: Tennessee zip: 37920 country: United States name: Shauntá M Chamberlin role: CONTACT phone: 865-305-5061 email: schamberlin@utmck.edu lat: 35.96064 lon: -83.92074 facility: University of Tennessee Health Science Center/Regional One Health status: RECRUITING city: Memphis state: Tennessee zip: 38103 country: United States name: Kay Ryan, PharmD role: CONTACT phone: 901-545-7840 email: kryan@regionalonehealth.org lat: 35.14953 lon: -90.04898 hasResults: False