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Medication Reviews ...
Medication Reviews Bridging Healthcare (MedBridge) : Study protocol for a pragmatic cluster-randomised crossover trial
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- Kempen, Thomas (författare)
- Uppsala universitet,Klinisk farmakogenomik och osteoporos
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- Bertilsson, Maria (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Lindner, Karl-Johan (författare)
- Pharmacy Department, Västmanland County Council, Västerås, Sweden
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- Sulku, Johanna (författare)
- Uppsala universitet,Centrum för klinisk forskning, Gävleborg,Reg Gavleborg, Dept Dev, Gavle, Sweden
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- Nielsen, Elisabet I., 1973- (författare)
- Uppsala universitet,Institutionen för farmaceutisk biovetenskap
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- Högberg, Angelica (författare)
- Reg Gavleborg, Dept Dev, Gavle, Sweden
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- Vikerfors, Tomas (författare)
- Vasteras Hosp, Dept Infect Dis, Vasteras, Sweden
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- Melhus, Håkan (författare)
- Uppsala universitet,Klinisk farmakogenomik och osteoporos
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- Gillespie, Ulrika (författare)
- Uppsala universitet,Institutionen för farmaceutisk biovetenskap
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(creator_code:org_t)
- Elsevier BV, 2017
- 2017
- Engelska.
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Ingår i: Contemporary Clinical Trials. - : Elsevier BV. - 1551-7144 .- 1559-2030. ; 61, s. 126-132
- Relaterad länk:
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http://www.ijic.org/...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Mismanaged prescribing and use of medication among elderly puts major pressure on current healthcare systems. Performing a medication review, a structured critical examination of a patient's medications, during hospital stay with active follow-up into primary care could optimise treatment benefit and minimise harm. However, a lack of high quality evidence inhibits widespread implementation. This manuscript describes the rationale and design of a pragmatic cluster-randomised, crossover trial to fulfil this need for evidence.AIM: To study the effects of hospital-initiated comprehensive medication reviews, including active follow-up, on elderly patients' healthcare utilisation compared to 1) usual care and 2) solely hospital based reviews.DESIGN: Multicentre, three-treatment, replicated, cluster-randomised, crossover trial.SETTING: 8 wards with a multidisciplinary team within 4 hospitals in 3 Swedish counties.PARTICIPANTS: Patients aged 65years or older, admitted to one of the study wards.EXCLUSION CRITERIA: Palliative stage; residing in other than the hospital's county; medication review within the last 30days; one-day admission.INTERVENTIONS: 1, comprehensive medication review during hospital stay; 2, same as 1 with the addition of active follow-up into primary care; 3, usual care.PRIMARY OUTCOME MEASURE: Incidence of unplanned hospital visits during a 12-month follow-up period.DATA COLLECTION AND ANALYSES: Extraction and collection from the counties' medical record system into a GCP compliant electronic data capture system. Intention-to-treat-analyses using hierarchical models.RELEVANCE: This study has a high potential to show a reduction in elderly patients' morbidity, contributing to more sustainable healthcare in the long run.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
Nyckelord
- Cluster analysis
- Crossover design
- Inappropriate prescribing
- Integrated health care systems
- Medication review
- Pragmatic clinical trial
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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