Clinical trial NCT00351676: Capturing Outcomes of Clinical Activities Performed by a Rounding Pharmacist Practising in a Team Environment
Official title: Capturing Outcomes of Clinical Activities Performed by a Rounding Pharmacist Practising in a Team Environment (COLLABORATE)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Heart Failure, Congestive
Pulmonary Disease, Chronic Obstructive
Pneumonia
Diabetes Mellitus, Type 2
Coronary Arteriosclerosis
Keywords: Drug Therapy
Hospitals, Teaching
Hospitals, Community
Interprofessional relations
Patient Care Team
Pharmacists
Pharmacy Service, Hospital
Comparative Study
Hospitalization
Lead sponsor: University of Alberta
Sponsor class: OTHER
Collaborators: name: Capital Health, Canada
First posted: 2006-07-13
Enrollment: 452
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: Improvement in proportion of quality indicators achieved, for target diseases as a most responsible or primary diagnosis, between groups.
timeFrame: in hospital
Secondary outcomes:
measure: Differences in condition-specific achievement of drug therapy quality indicators;
timeFrame: in hospital
measure: Differences in 6 month hospital readmission rate;
timeFrame: 6 months
measure: Differences in number, type, acceptance rate, and expected impact of all pharmacist interventions;
timeFrame: in hospital
measure: Qualitative evaluation of the impact of the intervention via interviews with the participating pharmacists and physicians.
timeFrame: in hospital
Other outcomes:
Locations:
city: Edmonton
country: Canada
facility: Royal Alexandra Hospital
state: Alberta
city: Edmonton
country: Canada
facility: University of Alberta Hospital
state: Alberta
city: Edmonton
country: Canada
facility: Grey Nuns Community Hospital
state: Alberta
Study officials:
affiliation: University of Alberta
name: Ross T. Tsuyuki, PharmD, MSc
role: PRINCIPAL_INVESTIGATOR
References:
citation: Makowsky MJ, Koshman SL, Midodzi WK, Tsuyuki RT. Capturing outcomes of clinical activities performed by a rounding pharmacist practicing in a team environment: the COLLABORATE study [NCT00351676]. Med Care. 2009 Jun;47(6):642-50. doi: 10.1097/MLR.0b013e3181926032.
citation: Makowsky MJ, Schindel TJ, Rosenthal M, Campbell K, Tsuyuki RT, Madill HM. Collaboration between pharmacists, physicians and nurse practitioners: a qualitative investigation of working relationships in the inpatient medical setting. J Interprof Care. 2009 Mar;23(2):169-84. doi: 10.1080/13561820802602552.