Clinical trial NCT06040151: Evaluating Mobile-based Medication Reconciliation by Patients at Home
Official title: Evaluating Mobile-based Medication Reconciliation by Patients at Home: Feasibility, Quality and Time Investments by Pharmacy Technicians
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Patients
Keywords: Patients with all conditions are eligible
Lead sponsor: Erasmus Medical Center
Sponsor class: OTHER
First posted: 2023-09-15
Enrollment: 39
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All adult patients (18 years or older) who are asked to complete medication reconciliation before a planned admission to the clinical ward of selected pilot departments in Erasmus MC are eligible to participate in this study.

Brief summary: Medication reconciliation (MR) is essential to limit drug-related problems that occur during care transitions in and out of care institutions. Pharmacy-led medication reconciliation has been shown to reduce medication discrepancies, preventable harm and hospital readmissions. However, these consultations are time-consuming. The Erasmus Medical Center is currently developing a mobile-based patient portal. After receiving an invitation to perform medication reconciliation in the app, patients can review their medication and allergies at home. Next, pharmacy technicians manually verify all patient-entered data on completeness and quality. The investigators hypothesize that mobile-based medication reconciliation results in increased patient insight. Yet, it is unknown if mobile-based medication reconciliation is feasible, saves time, and is of high quality.

Therefore, the primary study objectives are to assess (1) the feasibility of patients performing medication reconciliation using a mobile-based patient portal, (2) the time investment of pharmacy technicians in mobile-based medication reconciliation (and related costs), in comparison to standard practice, and (3) the quality of patients' pre-verified medication lists. The secondary study objective is to assess patients' and pharmacy technicians' acceptability of performing medication reconciliation using a mobile-based patient portal.

This is a prospective quality evaluation study assessing mobile-based medication reconciliation. All adult patients (18 years or older) who are admitted to (a selection of) clinical ward in Erasmus Medical Center and who are asked to complete medication reconciliation are eligible. In the patient app, patients review ('pre-verify') their medications and allergies, after which pharmacy technicians check and manually approve ('verify') all patient-entered data and determine whether a follow-up interview is needed.

Feasibility is defined as the successful completion rate of digital medication reconciliation, and the need for additional interviews. Time investment by pharmacy technicians (and related costs) are determined by timing the duration of all patient-bound medication reconciliation-related tasks, both in standard care and when using mobile-based reconciliation. The quality of verification is determined by comparing patients' pre-verified medication list to pharmacy technician-verified lists. Acceptability is defined as the perceived usability of medication reconciliation by patients and by pharmacy technicians.


Eligibility criteria: Inclusion Criteria:

* 18 years or older
* Planned admission to the clinical ward of participating pilot departments in Erasmus MC

Exclusion Criteria:

* No potential subject will be excluded from participation in this study.

Primary outcomes:
measure: Feasibility (1/4): completion rate of digital MR by patients
timeFrame: During quality evaluation of the patient app, an average of 3 months
measure: Feasibility (2/4): the time it takes patients to perform digital MR (in minutes)
timeFrame: During quality evaluation of the patient app, an average of 3 months
measure: Feasibility (3/4): the need for live, follow-up interviews after performing digital MR
timeFrame: During quality evaluation of the patient app, an average of 3 months
measure: Feasibility (4/4): how often the helpdesk was contacted
timeFrame: During quality evaluation of the patient app, an average of 3 months
measure: The time investment by pharmacy technicians per patient in the digital MR process, compared to the current situation (in minutes)
timeFrame: Before launch of the patient app, during an average of 2 months, and during quality evaluation of the patient app, an average of 3 months
measure: The quality of a patient's pre-verified medication list, compared to the pharmacy technician's verified medication list
timeFrame: During quality evaluation of the mobile-based medication reconciliation tool, an average of 3 months
Secondary outcomes:
measure: Acceptability (1/2): defined as the perceived usability of mobile-based MR by patients, assessed using short in-app questionnaires (VAS 1-5)
timeFrame: During quality evaluation of the mobile-based medication reconciliation tool, an average of 3 months
measure: Acceptability (2/2): defined as the perceived usability of mobile-based MR by patients and pharmacy technicians, assessed using short qualitative interviews with both patients and pharmacy technicians
timeFrame: During quality evaluation of the mobile-based medication reconciliation tool, an average of 3 months
Other outcomes:
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