Medication Reconciliation for Patients Over 65 Years Old : Cost Analysis of the Process Implemented in the Polyvalent Internal Medical Unit of Rennes University Hospital

Study Overview
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Brief Summary
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Among the strategies to secure the patient's care path, medication reconciliation is a powerful approach for the prevention and interception of medication errors.

Detailed Description
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All medication errors are not serious. Nevertheless 4 studies show that respectively 5.6%, 5.7%, 6.3% and 11.7% of the medication errors intercepted by medication reconciliation (MR) could have had major, critical or catastrophic consequences for patients. If the consequences of a medication error have a clinical or institutional translation for the patient, they can also directly impact the hospital or caregivers, for example by extending the average length of stay or by increasing the number of consultations or readmissions. The efficiency of the medication reconciliation approach has never been evaluated in France in comparison with standard care. Before initiating cost-effectiveness studies, we propose to conduct a micro-costing study to evaluate the production costs of this conciliation approach. The costs are almost exclusively related to human resources and the present study will assess the time spent by the different actors involved in the process.

Official Title
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Medication Reconciliation for Patients Over 65 Years Old : Cost Analysis of the Process Implemented in the Polyvalent Internal Medical Unit of Rennes University Hospital

Conditions
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Medication Reconciliation

Intervention / Treatment
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* Other: Cost analysis of medication reconciliation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients over 65 years old Patient non-institutionalized at entry For MR : Entry : patients admitted at UMIP between 09/04/2017 and 10/31/2017 Discharge : patients returning home or going to a rehabilitation service between 04/09/2017 and 31/10/2017 and having received MR evaluation Exclusion Criteria: Patients not returning home Refusal of participation Major persons subject to legal protection (safeguard of justice, guardianship), persons deprived of their liberty

Ages Eligible for Study
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Minimum Age: 65 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients admitted in the Polyvalent Internal Medical Unit<br>Patients over 65 years old admitted in the Polyvalent Internal Medical Unit (UMIP) of Rennes University Hospital between 09/04/2017 and 10/31/2017 or going back home or to a rehabilitation service during the same period. Cost analysis of medication reconciliation. | Other: Cost analysis of medication reconciliation<br>* The MR at entry is performed by the pharmaceutical team as soon as possible after admission. The sequences of the medical conciliation are attributed to the health professionals according to the recommendations of the French National Authority for Health (HAS). The MR at the discharge is carried out in collaboration between the pharmaceutical and medical teams. It associates the patient through pharmaceutical interview and relies on the sharing of informations related to the patient's medical treatments. These informations are synthesized in an output conciliation sheet transmitted in real time by secure messaging to the attending physician and the dispensing pharmacist. In parallel, the liaison letter and the patient discharge order are generated in order to guarantee a perfect homogeneity between all the documents transmitted at the patient's exit. MR sequences are attributed to health professionals according to the recommendations of the HAS.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time spent by professionals | Evaluation of the time spent by each professionals involved in the completion of each step of the MR process. | At the inclusion day | 
| Average cost of MR process | Evaluation of average cost of MR process at UMIP. Only costs related to human resources are considered. | At the inclusion day | 
| Number of unintentional discrepancies detected | Number of unintentional discrepancies detected during MR at admission of patients at UMIP. | At the inclusion day | 
| Severity of unintentional discrepancies detected | Severity of unintentional discrepancies detected during MR at admission of patients at UMIP. Evaluation based on the algorithm provided by the HAS. | At the inclusion day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Medication reconciliation, Care path, Prevention