Study protocol for the evaluation of pharmacist-participated medication reconciliation at county hospitals in China: a multicentre, open-label, assessor-blinded, non-randomised, controlled study

Yu, Aichen; Wei, Guilin; Chen, Fanghui; Wang, Zining; Fu, Mengyuan; Wang, Guoying; Wushouer, Haishaerjiang; Li, Xixi; Guan, Xiaodong; Shi, Luwen

doi:10.1136/bmjopen-2021-053741

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…We planned to conduct our intervention in seven county-level hospitals, but were only able to do so in six county-level hospitals, as one did not conduct the intervention as planned. Furthermore, due to the inaccessibility of the data, we could not estimate medical costs as described in the protocol [ 21 ] and were thus unable to conduct a cost-benefit analysis. Moreover, we conducted cluster-level intervention to eliminate contamination between the intervention and control group, but there might still be unpredictable leakage between colleagues at the same hospital, possibly diminishing the difference between the control and intervention groups and thus leading to an underestimation of the true effect of our intervention.…”

Section: Discussionmentioning

confidence: 99%

“…We obtained the ethical approval from the Peking University Institution Review Board (IRB00001052-21016) and all participating county-level hospitals. We performed the study and reported our findings per the CONSORT guidelines [ 19 , 20 ], registered it with the Chinese Clinical Trial Registry (ChiCTR2100045668), and published the protocol elsewhere [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of pharmacist-led medication reconciliation at county hospitals in China: A multicentre, open-label, assessor-blinded, nonrandomised controlled study

Fu,

Zhu,

Wei

et al. 2024

J Glob Health

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Background Due to a lack of related research, we aimed to determine the effectiveness of a pharmacist-led medication reconciliation intervention in China. Methods We conducted a multicentre, prospective, open-label, assessor-blinded, cluster, nonrandomised controlled study at six county-level hospitals, with hospital wards serving as the clusters. We included patients discharged from the sampled hospitals who were aged ≥60 years; had ≥1 studied diagnoses; and were prescribed with ≥3 medications at discharge. Patients in the intervention group received a pharmacist-led medication reconciliation intervention and those in the control group received standard care. We assessed the incidence of medication discrepancies at discharge, patients’ medication adherence, and health care utilisation within 30 days after discharge. Results There were 429 patients in the intervention group (mean age = 72.5 years, standard deviation (SD) = 7.0) and 526 patients in the control group (mean age = 73.6 years, SD = 7.1). Of the 1632 medication discrepancies identified at discharge, fewer occurred in the intervention group (1.9 per patient on average) than the control group (2.6 per patient on average).The intervention significantly reduced the incidence of medication discrepancy by 9.6% (95% confidence interval (CI) = −15.6, −3.6, P = 0.002) and improved patients’ medication adherence, with an absolute decrease in the mean adherence score of 2.5 (95% CI = −2.8, −2.2, P < 0.001). There was no significant difference in readmission rates between the intervention and control groups. Conclusions Pharmacist-led medication reconciliation at discharge from Chinese county-level hospitals reduced medication discrepancies and improved patients’ adherence among patients aged 60 years or above, though no impact on readmission after discharge was observed. Registration ChiCTR2100045668.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Evaluation of pharmacist-led medication reconciliation at county hospitals in China: A multicentre, open-label, assessor-blinded, nonrandomised controlled study

Fu,

Zhu,

Wei

et al. 2024

J Glob Health

Self Cite

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“… 21 In recent years, MR is still in an experimental stage in China. 22 For the BPMH to be obtained, at least two data sources are required, which may include a patient/family/caregiver interview, an EMR medication list, a patient prescription list/pill bottles, and a discharge summary. 11 However, there is a lack of information on which sources should be prioritized.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Medication Reconciliation in a Chinese Hospital: A Pilot Randomized Controlled Trial

Chai,

Liu,

Wang

et al. 2023

JMDH

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Background Implementing medication reconciliation (MR) was complex and challenging because of the variability in the guidance provided for conducting. The processes of MR adopted in China were different from that recommended by the World Health Organization. A pilot study to inform the design of a future randomized controlled trial to determine the effectiveness of these two workflows was undertaken. Methods Patients taking at least one home/regular medication for hypertension, diabetes, or coronary heart disease were recruited at admission, and then were randomized using a computer-generated random number in a closed envelope. In the study group, the pharmacist reviewed electronic medical record systems before communication with patients. In the control group, pharmacists communicated with patients at patient’s admission. The time investment of pharmacists for MR process, the number of unintended medication discrepancies, and physician acceptance were tested as outcome measures. Results One hundred and forty adult patients were randomized, of which 66 patients in the intervention received MR within 24 hours, while 58 patients in control received MR at some point during admission. The most common condition in the study group was hypertension (coronary heart disease in the control group). The workflow of the study group can save an average 7 minutes per patient compared with the WHO recommended process [17.5 minutes (IQR 14.00, 28.25) vs 24.5 minutes (IQR17.75, 35.25), p = 0.004]. The number of unintended discrepancies was 42 in the study group and 34 in the control group ( p = 0.33). Physicians’ acceptance in the study and control groups were 87.5% and 92.3%, respectively ( p = 0.87). Conclusion The results suggest that changes in outcome measures were in the appropriate direction and that the time limit for implementing MR can be set within 48 hours. A future multi-centre RCT study to determine the effectiveness of MR is feasible and warranted.

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Study protocol for the evaluation of pharmacist-participated medication reconciliation at county hospitals in China: a multicentre, open-label, assessor-blinded, non-randomised, controlled study

Cited by 2 publications

References 21 publications

Evaluation of pharmacist-led medication reconciliation at county hospitals in China: A multicentre, open-label, assessor-blinded, nonrandomised controlled study

Evaluation of pharmacist-led medication reconciliation at county hospitals in China: A multicentre, open-label, assessor-blinded, nonrandomised controlled study

Effectiveness of Medication Reconciliation in a Chinese Hospital: A Pilot Randomized Controlled Trial

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