NCT06610292

Effects of Pharmacist-led Medication Reconciliation Services on Geriatric Patients

Effects of Pharmacist-led Medication Reconciliation Services on Geriatric Patients At a Leading Military Hospital in Jordan

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 128 (actual)
• Sponsor: University of Jordan · Academic / Other
• Sex: All
• Age: 65 Years
• Healthy volunteers: Not accepted

Summary

This study aims to assess the effects of Pharmacist-led medication reconciliation on hospitalized elderly patients aged above 65 at a leading tertiary military hospital in Jordan.

Detailed description

A four-month randomized controlled trial was conducted at King Hussein Medical Hospital (KHMH), one of the Royal Military Medical Services (RMS) tertiary hospitals located in central Amman. During the study period, 128 patients were selected using convenience sampling. Later, medication histories were compared between pre-admission and admission records to obtain the Best Possible Medication History (BPMH) and identify medication discrepancies, which were categorized as either intentional (documentation errors) or unintentional discrepancies. The already selected patients were randomly allocated into two groups (intervention and control groups). Then, Pharmacist-led medication reconciliation services were provided to the intervention group and standard care was provided to the control group. Also at discharge the number of medication discrepancies was documented. Linear regression analysis was performed to assess risk factors associated with the occurrence of unintentional discrepancies. Within 30 days post-discharge, patients were assessed for any hospital re-admissions, emergency department visits and medication-related side effects.

Conditions

• Geriatric Patients
• Medication Reconcilitation Upon Hospital Admission
• Medication Reconciliation At Discharge
• Pharmacist-led Medication Reconciliation

Interventions

Type	Name	Description
OTHER	Pharmacist-led medication reconciliation services	Upon admission, information about patients Best Possible Medication History (BPMH) was extracted. Information on current medications, both regular and as-needed, was also recorded. All data were cross-referenced with the electronic records and verified through patients or caregivers interviews to create a comprehensive medication list. Then, comparison was conducted between standard care medication list and Pharmacist-led medication reconciliation list to identify any possible medication discrepancies. Also, during hospital stay and upon discharge emerging medication discrepancies were assessed and resolved. Moreover, the impacts on healthcare resources utilization within 30 days post-discharge was measured. This includes evaluating hospital re-admissions, emergency department visits, and the occurrence of any adverse drug events (ADEs).

Timeline

• Start date: 2018-06-24
• Primary completion: 2018-10-13
• Completion: 2018-10-13
• First posted: 2024-09-24
• Last updated: 2024-09-24

Locations

1 site across 1 country: Jordan