Medication Intervention in Transitional Care to Optimize Outcomes & Costs for CKD & ESRD (CKD/ESRD-MIT)

Providence Medical Research Center

Status: Completed

Conditions: Chronic Kidney Disease; End-Stage Renal Disease

Treatments: Other: Medication Information Transfer Intervention; Other: Usual care for hospital discharge

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01459770

1R34DK094016-01

RFP # 7 (Other Grant/Funding Number)

R34DK094016-01 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Transitional care strategies focused on enhancing the accuracy and comprehensiveness of medication information transfer will lead to improved health outcomes among hospitalized patients with chronic kidney disease.

Full description

Patients with CKD and ESRD have more co-morbidities, are hospitalized more often and for longer lengths of stay, and incur greater healthcare costs than patients with other chronic conditions. Enhanced hospital to home transitional care interventions have been shown to improve medication information transfer, reduce hospital readmissions, and slow the progression of declining health in the general population of hospitalized patients. What is not known is the impact enhanced transitional care can have for a very high-risk population, such as those with CKD and ESRD. Interventions that prevent or slow CKD progression, i.e. blood pressure control and intensive glycemic control in patients with diabetes, are all highly dependent on meticulous medication management.

For hospitalized patients with CKD or ESRD who are transitioning to home, accurate and comprehensive information transfer is essential to optimal medication management. CKD and ESRD patients are in critical need of improved transitional care that includes accurate and comprehensive medication information transfer. The main objective of this application is to pilot-test the effectiveness of a medication information transfer intervention to improve clinically-relevant outcomes. To this end, the following Specific Aims will be achieved: 1. Evaluate the impact of transitional care interventions on acute care utilization following hospital discharge among patients with CKD or ESRD. 2. Evaluate the impact of transitional care strategies on management of CKD or ESRD management and complications.

Enrollment: 120 patients

Sex: All

Ages: 21+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria for CKD arm:

1. Hospitalized patients
2. > 21 years of age
3. Diagnosis of CKD stages 3-5, not treated by dialysis

Inclusion Criteria for ESRD arm:

1. Hospitalized patients
2. > 21 years of age
3. Patients treated with hemodialysis or peritoneal dialysis

Exclusion Criteria:

1. Kidney Transplant

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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120 participants in 2 patient groups

control

Active Comparator group

Description:

usual care for hospital discharge: 1. CKD group 2. ESRD group

Treatment:

Other: Usual care for hospital discharge

intervention

Active Comparator group

Description:

pharmacist administered medication information transfer intervention 1. CKD group 2. ESRD group

Treatment:

Other: Medication Information Transfer Intervention