Using novel Canadian resources to improve medication reconciliation at discharge: study protocol for a randomized controlled trial.
Trials
; 13: 150, 2012 Aug 27.
Article
em En
| MEDLINE
| ID: mdl-22920446
ABSTRACT
BACKGROUND:
Adverse drug events are responsible for up to 7% of all admissions to acute care hospitals. At least 58% of these are preventable, resulting from incomplete drug information, prescribing or dispensing errors, and overuse or underuse of medications. Effective implementation of medication reconciliation is considered essential to reduce preventable adverse drug events occurring at transitions between community and hospital care. An electronically enabled discharge reconciliation process represents an innovative approach to this problem. METHODS/DESIGN:
Participants will be recruited in Quebec and are eligible for inclusion if they are using prescription medication at admission, covered by the Quebec drug insurance plan, admitted from the community, 18 years or older, admitted to a general or intensive care medical or surgical unit, and discharged alive. A sample size of 3,714 will be required to detect a 5% reduction in adverse drug events. The intervention will comprise electronic retrieval of the community drug list, combined with an electronic discharge reconciliation module and an electronic discharge communication module. The primary outcomes will be adverse drug events occurring 30 days post-discharge, identified by a combination of patient self-report and chart abstraction. All emergency room visits and hospital readmission during this period will be measured as secondary outcomes. A cluster randomization approach will be used to allocate 16 medical and 10 surgical units to electronic discharge reconciliation and communication versus usual care. An intention-to-treat approach will be used to analyse data. Logistic regression will be undertaken within a generalized estimating equation framework to account for clustering within units.DISCUSSION:
The goal of this prospective trial is to determine if electronically enabled discharge reconciliation will reduce the risk of adverse drug events, emergency room visits and readmissions 30 days post-discharge compared with usual care. We expect that this intervention will improve adherence to medication reconciliation at discharge, the accuracy of the community-based drug history and effective communication of hospital-based treatment changes to community care providers. The results may support policy-directed investments in computerizing and training of hospital staff, generate key requirements for future hospital accreditation standards, and highlight functional requirements for software vendors. TRIAL REGISTRATION NCT01179867.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Alta do Paciente
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Serviço de Farmácia Hospitalar
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Projetos de Pesquisa
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Sistemas de Informação em Farmácia Clínica
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Serviços Comunitários de Farmácia
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Continuidade da Assistência ao Paciente
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Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
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Reconciliação de Medicamentos
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Guideline
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Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article