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1285 IMPLEMENTATION OF A MEDICINE MANAGEMENT PLAN TO REDUCE MEDICATION-RELATED HARM IN OLDER PEOPLE POST-HOSPITAL DISCHARGE - AN RCT. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Medication-related harm (MRH) events are increasing among older adults especially in the 8-weeks after hospital discharge. The Discharge Medical Service (DMS), a UK initiative, aims to reduce post-discharge MRH. In this study, we will compare the clinical, economic, and service outcomes of the DMS.
Method
Using a randomised control trial design, 682 older adults ≥ 65years due for hospital-discharge will be recruited. Participants will be randomized to either intervention arm (medicine management plan (MMP) and DMS), or control arm (DMS only) using a 1:1 stratification. The MMP includes patient and carer education about MRH, copy of discharge medications, and MRH risk score calculated using a validated prediction tool (1). Data collection includes patient clinical and social demographics, and admission and discharge medications. At 8-weeks post discharge, study pharmacist will verify MRH through patient telephone interview, and review of patients’ GP records.
Data Analysis
Univariate analysis will be done for baseline variables comparing the intervention and control arms. Variables known to be associated with MRH will be described by the randomisation groups. Further multivariate logistic regression will be done incorporating these variables. Economic evaluation will compare the cost-of-service use among the two arms and modelled to provide national estimates. Qualitative data from focus group interviews at participating hospital sites will explore practitioners’ understanding and acceptance of the DMS and MMP.
Conclusion
This study will inform the use of a validated MRH risk prediction tool, and provide a clinical, and economic evaluation of the DMS and MMP in the NHS. The study has ethics approval and is adopted in the national ageing research portfolio. We are seeking additional sites.
Reference
1. Parekh N, Ali K, Davies JG et al. Medication-related harm in older adults following hospital discharge: development and validation of a prediction tool. BMJ Quality and Safety 2020; 29: 142–53.
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IPD2.02 Real-world outcomes in patients with CF treated with ivacaftor: 2016 US and UK CF Registry analyses. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30286-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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IPD2.01 Disease progression in patients with CF treated with ivacaftor: analyses of real-world data from the US and UK CF Registries. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30285-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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P90 The north-south divide: regional inequalities in demographic characteristics and clinical outcomes in patients with cystic fibrosis in england–a population based cross-sectional study using uk CF registry data. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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ePS03.2 Real-world outcomes in patients (pts) with cystic fibrosis (CF) treated with ivacaftor (IVA): analysis of 2014 US and UK CF registries. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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25 Real-world outcomes in young (6- to 12-year-old) patients (pts) with cystic fibrosis (CF) treated with ivacaftor (IVA): analysis of 2014 US and UK CF registries data. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30265-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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ePS03.1 Disease progression in patients (pts) with cystic fibrosis (CF) treated with ivacaftor (IVA): analysis of real-world data from the UK CF Registry. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30205-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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