NCT02122965

The Effect of Medication Review in High-risk Emergency Department Patients

The Effect of Medication Review in High-risk Emergency Department Patients: Evaluation of a Quality Improvement Program

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 10,805 (actual)
• Sponsor: University of British Columbia · Academic / Other
• Sex: All
• Age: 19 Years
• Healthy volunteers: Not accepted

Summary

Adverse drug events are unintended and harmful events related to medication use and a leading cause of emergency department visits, unplanned hospital admissions and deaths. In the emergency department, physicians frequently misdiagnose adverse drug events leading to treatment delays. Our objective is to evaluate the effect of pharmacist-led medication review in high-risk emergency department patients on prolonged hospital stay. This prospective multi-centre, quasi-randomized study is nested within an existing quality improvement program. Triage nurses flag incoming emergency department patients at high-risk for adverse drug events by applying a clinical decision rule consisting of four variables (co-morbid conditions, antibiotic use within 7 days, medication changes within 28 days, and age). Consecutive eligible high-risk patients are enrolled into the medication review study, and systematically allocated to pharmacist-led medication review or usual care. In the intervention group, medication review pharmacists collect best-possible medication histories, review the patient's medications for appropriateness and adverse drug events, and communicate the results of medication review to patients, caregivers and physicians. In the usual care group, physicians refer patients to onsite pharmacists for medication management questions on an as needed basis. Health outcomes are assessed using anonymized data linkage to administrative health databases. The primary outcome is the percent of days spent in hospital during the first 30 days after the index emergency department visit

Conditions

• Adverse Drug Events
• Adverse Drug Reactions
• Medication-related Problems

Interventions

Type	Name	Description
OTHER	Pharmacist-led medication review	Medication review is a structured, critical examination of a patient's medications with the objective of reaching agreement with the patient about treatment, optimizing the medications' impact, and minimizing the number of medication-related problems and adverse drug events.

Timeline

• Start date: 2012-12-01
• Primary completion: 2013-02-01
• Completion: 2014-02-01
• First posted: 2014-04-25
• Last updated: 2014-04-25

Locations

3 sites across 1 country: Canada