Protocol for a randomised controlled trial evaluating the impact of a community pharmacy discharge medication reconciliation service on unplanned hospital readmissions – The DCMedsRec trial
| Autor: | Kevin McNamara, Cathy Ngo, Laura Fanning, Bill Suen, Stefanie Johnston, Peteris Darzins, Suzanne Mary Caliph, David A. Taylor, Gregory Duncan |
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| Rok vydání: | 2021 |
| Předmět: |
Psychological intervention
Pharmaceutical Science Pharmacy Pharmacists Patient Readmission 030226 pharmacology & pharmacy law.invention 03 medical and health sciences Medication Reconciliation 0302 clinical medicine Randomized controlled trial law Intervention (counseling) Health care Humans Medicine 030212 general & internal medicine Hospital pharmacy Randomized Controlled Trials as Topic Pharmacies business.industry Medical record Australia medicine.disease Patient Discharge Clinical trial Number needed to treat Medical emergency Pharmacy Service Hospital business New Zealand |
| Zdroj: | Research in Social and Administrative Pharmacy. 17:460-465 |
| ISSN: | 1551-7411 |
| Popis: | Introduction A substantial proportion of hospital admissions and readmissions are directly attributable to preventable medication-related harm. Interventions that reduce these harms could avert significant suffering and healthcare costs. Objectives The Discharge Medications Reconciliation (DCMedsRec) trial will evaluate a structured medication reconciliation service by community pharmacists post hospital discharge on the risk of 30-day unplanned readmission. Electronic access to the Hospital Discharge Summary via My Health Record will underpin this service. Methods DCMedsRec is a non-blinded randomised controlled trial of an intervention by community pharmacists within 30 days of hospital discharge in Melbourne, Australia. Patients discharged from hospital will be assessed by a hospital pharmacist for trial eligibility. If eligible, patients will be randomised to either a control or intervention group by sequentially marked sealed envelopes. Intervention patients receive an invitation to the DCMedsRec service at a participating community pharmacy, who will be reimbursed. Control patients will receive usual care. A Number Needed to Treat of 20 will require 293 DCMedsRec interventions to achieve 80% power. With a predicted 30% uptake, a minimum sample of 977 in the intervention arm is required. Outcomes The primary outcome will be the rate of 30-day unplanned hospital readmission in intervention (DCMedsRec) versus usual care groups. Secondary analyses will evaluate the economic impact of the intervention and a qualitative thematic analysis of the experience and value of the service for both patients and service providers (community pharmacists). Analysis An intention-to-treat analysis will be used to assess intervention efficacy and results will be reported using risk ratios with 95% confidence intervals. Cost-effectiveness analysis will compare within-trial costs and outcomes of the DCMedsRec versus usual care from a health-system perspective. Trial registration and funding This trial is registered with the Australian and New Zealand Clinical Trials Register and funded by the Australian Digital Health Agency. |
| Databáze: | OpenAIRE |
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