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Adverse Drug Events | Pharmacists and Pharmacy Technicians to Improve Admission Medication History Accuracy

Adverse Drug Events research study

What is the primary objective of this study?

We tested two interventions to improve the accuracy of medication histories obtained at hospital admission. The interventions target elderly and chronically ill patients prone to erroneous medication histories and resultant medication errors. For targeted patients, we tested the effect of using pharmacists and pharmacy technicians to obtain an initial medication history. This was studied using a randomized controlled trial of usual care (which involves nurses and physicians) vs usual care + pharmacists vs usual care + pharmacy technicians to obtain an admission medication history. The overarching hypothesis was that by leveraging pharmacists and pharmacy technicians we can minimize admission medication history errors and related downstream events.

Who is eligible to participate?

Inclusion criteria: - Accessed via EHR, were: >=10 chronic prescription medications - History of acute myocardial infarction or congestive heart failure - Admission from skilled nursing facility - History of transplant, or active anticoagulant, insulin, or narrow therapeutic index medications. Exclusion criteria:(supersedes inclusion criteria) - Admitted to pediatric, trauma or transplant services with pharmacists

Which medical condition, disease, disorder, syndrome, illness, or injury is researched?

Adverse Drug Events

Study Interventions

Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.

Other:Pharmacist obtains admission medication history

Other:Pharmacy technician obtains admission medication history

Study Arms

Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.

Usual carePhysicians and nurses obtain admission medication history.

Pharmacist obtains home med hxPharmacist obtains admission medication history, although usual care practices may also continue.

Pharm tech obtains home med hxPharmacy technician obtains admission medication history, although usual care practices may also continue.

Study Status

Completed

Start Date: January 2014

Completed Date: October 2016

Phase: N/A

Type: Interventional

Design:

Primary Outcome: Mean Severity-weighted Admission Medication History (AMH) Error Score

Secondary Outcome: Mean Severity-Weighted Admission Medication Order (AMO) Error Score

Study sponsors, principal investigator, and references

Principal Investigator: Joshua M Pevnick, MD, MSHS

Lead Sponsor: Cedars-Sinai Medical Center

Collaborator: National Institutes of Health (NIH)

More information:https://clinicaltrials.gov/show/NCT02026453

Pevnick JM, Palmer KA, Shane R, Wu CN, Bell DS, Diaz F, Cook-Wiens G, Jackevicius CA. Potential benefit of electronic pharmacy claims data to prevent medication history errors and resultant inpatient order errors. J Am Med Inform Assoc. 2016 Sep;23(5):942-50. doi: 10.1093/jamia/ocv171. Epub 2016 Jan 17.

Nguyen CB, Shane R, Bell DS, Cook-Wiens G, Pevnick JM. A Time and Motion Study of Pharmacists and Pharmacy Technicians Obtaining Admission Medication Histories. J Hosp Med. 2017 Mar;12(3):180-183. doi: 10.12788/jhm.2702.

Pevnick JM, Nguyen C, Jackevicius CA, Palmer KA, Shane R, Cook-Wiens G, Rogatko A, Bear M, Rosen O, Seki D, Doyle B, Desai A, Bell DS. Improving admission medication reconciliation with pharmacists or pharmacy technicians in the emergency department: a randomised controlled trial. BMJ Qual Saf. 2018 Jul;27(7):512-520. doi: 10.1136/bmjqs-2017-006761. Epub 2017 Oct 6.

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