Medicines Reconciliation at an Intensive Care Unit

Study Overview
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Brief Summary
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This study evaluates the effect of performing medicines reconciliation on patients admitted to an intensive care unit. Half of the patients will receive a medicines reconciliation at the intensive care unit. The other half will not. All included patients will receive medicines reconciliation after transfer to the ward.

Detailed Description
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Transfer of patients from one level of care to another is known to increase the risk of medication errors. Medication reconciliation is an accepted intervention to increase the knowledge on the patients medication use, thus reducing the risk of avoidable medication errors. For patients in the intensive care unit treatment of the imminent threat is obviously the most important. Nevertheless, knowledge about previous medications are important.

Official Title
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Medicines Reconciliation at an Intensive Care Unit

Conditions
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Medicines Reconciliation, Intensive Care Unit

Intervention / Treatment
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* Other: Medication reconciliation at the ICU
* Other: Medication Reconciliation at the Ward


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: belonging to the hospitals intake area written informed concent by the patient or his/her next to kin Exclusion Criteria: Patients without next to kin Not Norwegian speaking, in need of a translator medication reconciliation performed earlier Patients with Guillain-Barre or Myasthenia Gravis, due to long expectancy of stay Short life expectancy, decided in cooperation with the physician

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The included patients are randomized to either intervention or control group. The intervention group receives medicines reconciliation at the intensive care unit. The control group receive standard pharmaceutical care, which now does not include medicines reconciliation. After the patients are transferred to care at the ward, medicines reconciliation is performed for all patients.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>Receive medication reconciliation at the ICU, pluss medication reconciliation at the ward | Other: Medication reconciliation at the ICU<br>* Medication reconciliation performed according to Integrated Medicines Management model<br>Other: Medication Reconciliation at the Ward<br>* Medication reconciliation performed according to Integrated Medicines Management model<br>|
| Other: Control group<br>No intervention at the ICU, medication reconciliation at the ward | Other: Medication Reconciliation at the Ward<br>* Medication reconciliation performed according to Integrated Medicines Management model<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with at least one discrepancy between medications listed on hospital chart and medications used at home before hospital admittance | Medications listed on the medication chart were recorded on a predefined form, this included information on dosage form, strength, dosage and administration time for each drug. The pharmacist performed medicines reconciliation either by interviewing the patient or by gathering information from other sources as the patient's general practitioner, next-to-kin or if relevant nursing home. Any deviations between the information from the medication chart and information obtained during medicines reconciliation was defined as a discrepancy. | Medicines reconciliation is performed at randomisation and within 48 hours after transmission to the ward, assessed up to 28 days after randomisation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Retrospective evaluation on the clinical relevance of the observed medical discrepancies | One clinical pharmacist and one senior geriatrician retrospectively asses the potential clinical relevance of the registered discrepancies. The expert panel use the following information for each patient when assessing the clinical relevance: medication list before and after reconciliation, age, gender, reason for hospitalisation, former and current diseases and the level of care before admission | Retrospectively, based on the information gathered from the day of randomisation up until 28 days after randomisation |