Eliminating Risk of Preventable Adverse Drug Events at the Hospital-community Interface of Care

Study Overview
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Brief Summary
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This initiative aims to decrease the risk of medication errors at the hospital-community interface as well as health system utilization following hospital discharge by implementing a pharmacist-led medication reconciliation in the patients' home within 72 hours of hospital discharge.

Detailed Description
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The goals of this initiative are to decrease the risk for medication errors at the hospital community interface of care, thus decreasing preventable adverse drug events and preventable drug-related health system utilization following hospital discharge. This initiative has four objectives that aim to: Develop and test a community-based medication reconciliation process/intervention. Design and conduct a randomized controlled trial to examine the impact of the intervention on post-discharge health services utilization by comparing a set of outcome variables between intervention and non-intervention groups. Design a risk prediction model that helps identify patients discharged from in-patient care with the highest level of need for the intervention. Determine whether a community-based medication reconciliation process/intervention adds risk reduction value to individuals who have undergone an in-hospital medication reconciliation.

Official Title
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Eliminating Risk of Preventable Adverse Drug Events at the Hospital-community Interface of Care: to Develop and Test a Community-based Medication Reconciliation Program and a Risk Prediction Model That Identifies High-risk Patient Groups

Conditions
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Adverse Drug Events

Intervention / Treatment
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* Behavioral: Medication Reconciliation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients attending the WestView Health Centre Medicine/Family Health Unit with at least one medication at discharge. Exclusion Criteria: First Nations persons Residents of continuing care or assisted living facilities Persons not residing in the Edmonton, AB, Canada region Persons who obtain a score of 19 or less on the Mini Mental State Examination (MMSE)

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Medication Reconciliation Intervention<br>Participants receiving a pharmacist-led home intervention conducted within 72 hours of hospital discharge aimed at identifying and correcting medication discrepancies. | Behavioral: Medication Reconciliation<br>* A pharmacist-led home intervention conducted within 72 hours of hospital discharge aimed at correcting and identifying medication discrepancies.<br>|
| No Intervention: Medication Reconciliation Non-Interven.<br>Participants not receiving a pharmacist-led home intervention conducted within 72 hours of hospital discharge aimed at identifying and correcting medication discrepancies. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health Services Utilization 3 Months Following Hospital Discharge | Mean health services utilization 3 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments. | 3 Months | 
| Health Services Utilization 6 Months Following Hospital Discharge | Mean health services utilization 6 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments. | 6 Months | 
| Health Services Utilization 9 Months Following Hospital Discharge | Mean health services utilization 9 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments. | 9 Months | 
| Health Services Utilization 12 Months Following Hospital Discharge | Mean health services utilization 12 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments. | 12 months | 
| Health Services Utilization 18 Months Following Hospital Discharge | Mean health services utilization 18 months following hospital discharge. The specific health services utilization was re-admission to hospital, admission to home care, admission to long-term care and visits to emergency departments. | 18 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Adverse Drug Events, Medication Reconciliation, Pharmacist-led Intervention