Clinical trial NCT03695081: Patient Pathway Pharmacist - Optimal Drug-related Care
Official title: Patient Pathway Pharmacist: Drug Optimisation for Hip Fracture Patients - Facilitating a Safe Patient Handover: a Descriptive Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hip Fractures
Aging
Patient Fall
Keywords: Medicine review
Patient handoff
Patient hand over
Intertrochanteric fractures
Trochanteric fractures
Subtrochanteric fractures
Hospital readmission
Hospital readmissions
Injuries, Hip
Hospitalization
Hospitalisation
Hip
Fracture
Femoral fractures
Femoral neck fractures
Medication errors
Medication review
Medication reconciliation
Lead sponsor: Sykehuset i Vestfold HF
Sponsor class: OTHER
Collaborators: name: Hospital Pharmacy Enterprise, South Eastern Norway
First posted: 2018-10-03
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Intervention model description: An intervention group is compared to a cross-sectional retrospective group.

A group of 60 patients with hip fracture will get an intervention by a clinical pharmacist who performs medication reconciliation and medication review during hospitalisation, they will receive a discharge summary where the medication part is optimised. After six weeks the patients will be get a follow-up with a second medication reconciliation and - review. This group will be compared with the last 50 patients with hip fracture who did not get the intervention.
Primary purpose: SUPPORTIVE_CARE

Brief summary: Medication errors represent the most common cause of patient injury and one of the most frequently reported health related deviation in Norway. The addition of a dedicated clinical pharmacist throughout the hip fracture patient pathway (patient pathway pharmacist) is believed to improve patient safety and ensure optimal drug-related patient care. The pharmacist will perform medication reconciliation at admission to hospital, medication review after surgery and assist physicians with discharge summary. Six weeks after discharge the patient pathway pharmacist will perform a second drug reconciliation and medication review. This study will assess the pharmacists' place and specific tasks in the patient pathway, describe areas where the pharmacist contribute to increased quality of care and assess the benefits and/or disadvantages experienced with introducing a patient pathway pharmacist. The estimated number of patients included is 60. Current practice will be determined by investigating the last 50 patients' medical record and a questionnaire to health care professionals involved in treatment of hip fracture patients. Data from medication reconciliation and drug review will be collected and compared to current practice. After the inclusion period, focus group surveys and/or semi-structured interviews will be executed to describe the perceived improvement in the quality of care. Primary endpoints are: 1) Medication reconciliation score at admission 2) Number of inappropriate drugs for elderly 3) Discharge summary score 4) Discharge summaries following procedure. Secondary endpoints are readmissions and mortality after 30 and 90 days. Qualitative endpoints: 1) Health care professionals experience of current drug-related practice 2) Experienced advantages and disadvantages of a patient pathway pharmacist.


Eligibility criteria: Inclusion Criteria:

* Hip fracture patients in Vestfold county, Norway

Exclusion Criteria:

* Patients under 18 years
* Terminally ill
* Hip fracture patients who do not follow the standardized patient pathway at Vestfold Regional Hospital
* Patients who do not consent to be included in the study

Primary outcomes:
measure: Discharge summary score
timeFrame: At discharge (estimated five days after fracture/inclusion)
measure: Admission summary score
timeFrame: At hospital admission (estimated to be within 24 hours after fracture)
measure: Discharge summaries written in accordance with procedure
timeFrame: At discharge (estimated five days after fracture/inclusion)
measure: Number of inappropriate drugs at discharge
timeFrame: During hospitalisation, after surgery (estimated to be within five days after fracture/inclusion)
Secondary outcomes:
measure: Readmission
timeFrame: 30 days after discharge
measure: Readmission
timeFrame: 90 days after discharge
measure: Death
timeFrame: 30 days after discharge
measure: Death
timeFrame: 90 days after discharge
Other outcomes:
measure: Experience of current practice
timeFrame: Prior to or during the early start of the intervention
measure: Experience of patient pathway pharmacist
timeFrame: Within three months after last included patient
Locations:
city: Tønsberg
country: Norway
facility: Vestfold Hospital Trust
Study officials:
References: