التفاصيل البيبلوغرافية
| العنوان: |
Improving medication prescribing-related outcomes for vulnerable elderly in transitions on high-risk medications (IMPROVE-IT HRM): a pilot randomized trial protocol |
| المؤلفون: |
Anne Holbrook, Dan Perri, Mitch Levine, Lawrence Mbuagbaw, Sarah Jarmain, Lehana Thabane, Jean-Eric Tarride, Lisa Dolovich, Sylvia Hyland, Victoria Telford, Jessyca Silva, Carmine Nieuwstraten |
| المصدر: |
Pilot and Feasibility Studies, Vol 10, Iss 1, Pp 1-14 (2024) |
| بيانات النشر: |
BMC, 2024. |
| سنة النشر: |
2024 |
| المجموعة: |
LCC:Medicine (General) |
| مصطلحات موضوعية: |
Medication management, Hospital discharge, High-cost user, Seniors, Clinical pharmacology, Pilot RCT, Medicine (General), R5-920 |
| الوصف: |
Abstract Background Seniors with recurrent hospitalizations who are taking multiple medications including high-risk medications are at particular risk for serious adverse medication events. We will assess whether an expert Clinical Pharmacology and Toxicology (CPT) medication management intervention during hospitalization with follow-up post-discharge and communication with circle of care is feasible and can decrease drug therapy problems amongst this group. Methods The design is a pragmatic pilot randomized trial with 1:1 patient-level concealed randomization with blinded outcome assessment and data analysis. Participants will be adults 65 years and older admitted to internal medicine services for more than 2 days, who have had at least one other hospitalization in the prior year, taking five or more chronic medications including at least one high-risk medication. The CPT intervention identifies medication targets; completes consult, including priorities for improving prescribing negotiated with the patient; starts the care plan; ensures a detailed discharge medication reconciliation and circle-of-care communication; and sees the patient at least twice after hospital discharge via virtual visits to consolidate the care plan in the community. Control group receives usual care. Primary outcomes are feasibility — recruitment, retention, costs, and clinical — number of drug therapy problems improved, with secondary outcomes examining coordination of transitions in care, quality of life, and healthcare utilization and costs. Follow-up is to 3-month posthospital discharge. Discussion If results support feasibility of ramp-up and promising clinical outcomes, a follow-up definitive trial will be organized using a developing national platform and medication appropriateness network. Since the intervention allows a very scarce medical specialty expertise to be offered via virtual care, there is potential to improve the safety, outcomes, and cost of care widely. Trial registration number ClinicalTrials.gov identifier: NCT04077281. |
| نوع الوثيقة: |
article |
| وصف الملف: |
electronic resource |
| اللغة: |
English |
| تدمد: |
2055-5784 |
| Relation: |
https://doaj.org/toc/2055-5784 |
| DOI: |
10.1186/s40814-024-01484-6 |
| URL الوصول: |
https://doaj.org/article/3b68f52389994a0090ffa67883a3f8ac |
| رقم الانضمام: |
edsdoj.3b68f52389994a0090ffa67883a3f8ac |
| قاعدة البيانات: |
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