Clinical trial NCT02087072: Collaborative Home Visits to Reduce Hospital Readmissions and Improve Medication Use During Transitions of Care
Official title: COLLABORATIVE HOME VISITS TO REDUCE HOSPITAL READMISSIONS AND IMPROVE MEDICATION USE DURING TRANSITIONS OF CARE
Study type: OBSERVATIONAL
Overall status: WITHDRAWN
Conditions: Transitional Care Coordination
Home Visits
Keywords: home visits
transitions of care
pharmacist
Lead sponsor: Ohio State University
Sponsor class: OTHER
Collaborators: name: American Society of Health-System Pharmacy Foundation
First posted: 2014-03-14
Enrollment: 0
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients will be selected from the OSU Healthy at Home program that have been recently discharged from the hospital.

Brief summary: The primary objective is to develop a sustainable practice model emphasizing home visits by a collaborative physician and pharmacist team to decrease unplanned emergency department visits and hospital readmissions at 30 and 90 days for high-risk home bound patients. Secondary objectives include (1) tracking the number, type, and severity of adverse drug events (ADE) and potential adverse drug events (pADE) that occur following hospital discharge and (2) resolving any identified ADE and pADE within 7 days of hospital discharge.

Adult patients will be scheduled for a home visit by the Healthy at Home Columbus program at the time of hospital discharge. The home visit will occur within 7 days of hospital discharge and will consist of a complete hospital and medication review by a physician or nurse practitioner and a pharmacist (including all lab tests, imaging studies, medication changes, and proposed plan of care at the time of discharge). The investigators hypothesize these home visits will reduce 30 and 90 days hospital readmission rates and ED visits.

The number of emergency department visits and unplanned hospital readmissions will be tracked at 30 and 90 days following discharge from the hospitalization that led to study enrollment. A comparison cohort of patients discharged in the 12 months prior to study initiation will be used to compare the effectiveness of the home visit program. The number and type of adverse drug events (ADE) and potential adverse drug events (pADE) that occur during transitions of care will also be characterized. All ADE and pADE will be resolved during the initial home visit and will be classified based on severity. All ADE and pADE will be evaluated independently by two pharmacist reviewers; each reviewer will independently assign a severity rating to each ADE and pADE.


Eligibility criteria: Inclusion Criteria:

* Adult patients discharged from the hospital in the last 7 days and with more than two chronic conditions and significant obstacles to accessing care in an office setting are eligible for study participation

Exclusion Criteria:

* Adult patients able to access care in an office setting.
* Adult patients discharged from the hospital greater than 7 days prior to the office visit.

Primary outcomes:
measure: Hospital Readmission
timeFrame: 30 days
Secondary outcomes:
measure: Emergency Department Visit
timeFrame: 30 days
Other outcomes:
measure: Number of drug related problems identified
timeFrame: 30 days
measure: Type of drug related problems identified
timeFrame: 30 days
Locations:
city: Columbus
country: United States
facility: The Ohio State University Division of General Internal Medicine Martha Morehouse
state: Ohio
Study officials:
References: