Capturing Outcomes of Clinical Activities Performed by a Rounding Pharmacist Practising in a Team Environment

Study Overview
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Brief Summary
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We, the researchers, propose to link a clinical pharmacist with an internal medicine or family medicine team to provide pharmaceutical care to all patients assigned to the team. The hypothesis is that through this team based approach, pharmacists will act as a resource for providing pharmacotherapeutic advice during the drug therapy decision making process and promote optimal drug use by identifying and resolving actual and potential drug related problems. This study is designed to test this hypothesis, by assessing the impact of this intervention on evidence based, quality of drug therapy indicators, for patients admitted with heart failure (HF), chronic obstructive pulmonary disease (COPD), community acquired pneumonia (CAP), type 2 diabetes mellitus (T2DM), and stable coronary artery disease (CAD).

Detailed Description
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The overall goal of the COLLABORATE study is to improve processes of care and patient outcomes by optimizing drug therapy via a hospital pharmacy practice model that integrates clinical pharmacists into the patient care team. The intervention consists of a clinical pharmacist assigned to the patient care team for the purpose of providing proactive clinical pharmacy services. The study pharmacist will be available during normal office hours 5 days per week to provide clarification of the patient's medication history, identify and resolve actual and potential patient specific drug related problems/issues, participate in patient care rounds, provide drug information to the patient care team, provide patient education and discharge medication counselling, and provide physician and/or nursing staff education. The anticipated pharmacist to patient ratio is approximately 1:20. Control patients will receive usual care. Usual care consists of reactive clinical pharmacy services (i.e. drug related issues identified as orders are received, or by patient profile review) provided by a ward based, not team based, clinical pharmacist.

Official Title
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Capturing Outcomes of Clinical Activities Performed by a Rounding Pharmacist Practising in a Team Environment (COLLABORATE)

Conditions
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Heart Failure, Congestive, Pulmonary Disease, Chronic Obstructive, Pneumonia, Diabetes Mellitus, Type 2, Coronary Arteriosclerosis

Intervention / Treatment
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* Behavioral: Integration of a team based clinical pharmacist
* Drug: Optimizing therapeutic treatments
* Behavioral: Optimizing processes of care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Consecutive patients > 18 years of age admitted to participating internal and family medicine teams during the 1 year study period will be eligible to receive the pharmacist intervention. For the purposes of data analysis, patients with a most responsible or primary diagnosis of HF, COPD, CAP, T2DM, and CAD will be included. Exclusion Criteria: Residence outside the Capital Health catchment Admitted for ≤ 2 days Palliative care Transferred to another team

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

Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Integration of a team based clinical pharmacist|nan|
|Drug: Optimizing therapeutic treatments|nan|
|Behavioral: Optimizing processes of care|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvement in proportion of quality indicators achieved, for target diseases as a most responsible or primary diagnosis, between groups. |  | in hospital | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differences in condition-specific achievement of drug therapy quality indicators; |  | in hospital | 
| Differences in 6 month hospital readmission rate; |  | 6 months | 
| Differences in number, type, acceptance rate, and expected impact of all pharmacist interventions; |  | in hospital | 
| Qualitative evaluation of the impact of the intervention via interviews with the participating pharmacists and physicians. |  | in hospital | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hospitals, Teaching, Drug Therapy, Hospitals, Community, Interprofessional relations, Patient Care Team, Pharmacists, Pharmacy Service, Hospital, Comparative Study, Hospitalization