Improving Medication Adherence Through a Transitional Care Pharmacy Practice Model

Wilkes University

Status and phase: Completed; Phase 3; Phase 2

Conditions: Pulmonary Disease, Chronic Obstructive; Heart Failure

Treatments: Procedure: Pharmacist Counseling

Study type: Interventional

Funder types: Other

Identifiers

NCT02047448

CPF

Details and patient eligibility

About

The purpose of this pilot study is to determine if medication adherence is improved by a transitional care pharmacy practice model designed to integrate hospital and community pharmacists in the care and education of patients with heart failure or COPD who are discharged from a community hospital to home. The hospital and community pharmacists will collaborate with each other, the patient, and other practitioners including the primary care physician, nurse, and case manager to prevent and correct medication-related problems and attempt to improve patient outcomes especially during the error-prone transition from hospital to home.

Enrollment: 180 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• admitted to hospital with a primary or secondary diagnosis of heart failure or COPD
• anticipated eventual discharge to home
• agreeable to participate in monthly counseling sessions (if randomized to intervention group) from a participating community pharmacist

Exclusion criteria

• presence of cognitive impairment or dementia that would significantly prevent effective patient education and counseling
• non English-speaking
• anticipated discharge to a long-term care or skilled nursing facility on a permanent basis
• permanent long-term care facility residents
• surgical patients
• hospice patients
• patients who die within 30 days of initial study hospitalization

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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180 participants in 2 patient groups

Control Group

No Intervention group

Description:

The control group will receive the current standard of care including medication reconciliation during hospitalization performed by a nurse or physician and education about discharge medications provided by the inpatient nurse. There will not be a pharmacist discharge care plan developed for this group. The patients will not be required to choose a participating community pharmacist and no counseling and education appointments will be scheduled. Any medication-related problems identified by the pharmacists and will be communicated as appropriate and resolved as is the standard of care. Any other interaction between the patient and their pharmacist will be according to the current standard of care.

Pharmacist Counseling

Experimental group

Description:

The hospital pharmacist will meet with the patient and complete medication reconciliation, assess the patient's understanding of the medications, and identify medication-related problems. The hospital pharmacist will complete a pharmacist discharge care plan and a copy will be sent to the participating community pharmacist. The patients will be scheduled for the first meeting with their community pharmacist within 1 week of hospital discharge. The community pharmacist will interview the patient about their general health and any current symptoms of heart failure or COPD, identify any additional medication-related problems, follow-up on any issues as described in the pharmacist discharge care plan, and provide patient education. The patients will then meet with their community pharmacist for counseling and patient education at monthly intervals for 6 months following hospital discharge.

Treatment:

Procedure: Pharmacist Counseling