OPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial
Abstract Background General practitioners (GP) and community pharmacists need information about hospital discharge patients’ medicines to continue their management in the community. This necessitates effective communication, collaboration, and reliable information-sharing. However, such handover is...
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2024-09-01
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| Online Access: | https://doi.org/10.1186/s13063-024-08496-w |
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| author | Laetitia Hattingh Melissa T. Baysari Holly Foot Tin Fei Sim Gerben Keijzers Mark Morgan Ian Scott Richard Norman Faith Yong Barbara Mullan Claire Jackson Leslie E. Oldfield Elizabeth Manias |
| author_facet | Laetitia Hattingh Melissa T. Baysari Holly Foot Tin Fei Sim Gerben Keijzers Mark Morgan Ian Scott Richard Norman Faith Yong Barbara Mullan Claire Jackson Leslie E. Oldfield Elizabeth Manias |
| author_sort | Laetitia Hattingh |
| collection | DOAJ |
| description | Abstract Background General practitioners (GP) and community pharmacists need information about hospital discharge patients’ medicines to continue their management in the community. This necessitates effective communication, collaboration, and reliable information-sharing. However, such handover is inconsistent, and whilst digital systems are in place to transfer information at transitions of care, these systems are passive and clinicians are not prompted about patients’ transitions. There are also gaps in communication between community pharmacists and GPs. These issues impact patient safety, leading to hospital readmissions and increased healthcare costs. Methods A three-phased, multi-method study design is planned to trial a multifaceted intervention to reduce 30-day hospital readmissions. Phase 1 is the co-design of the intervention with stakeholders and end-users; phase 2 is the development of the intervention; phase 3 is a stepped wedge cluster randomised controlled trial with 20 clusters (community pharmacies). Expected intervention components will be a hospital pharmacist navigator, primary care medication management review services, and a digital solution for information sharing. Phase 3 will recruit 10 patients per pharmacy cluster/month to achieve a sample size of 2200 patients powered to detect a 5% absolute reduction in unplanned readmissions from 10% in the control group to 5% in the intervention at 30 days. The randomisation and intervention will occur at the level of the patient’s nominated community pharmacy. Primary analysis will be a comparison of 30-day medication-related hospital readmissions between intervention and control clusters using a mixed effects Poisson regression model with a random effect for cluster (pharmacy) and a fixed effect for each step to account for secular trends. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry: ACTRN12624000480583p , registered 19 April 2024. |
| format | Article |
| id | doaj-art-16c800b542e34d73bf5d5a4879ed5693 |
| institution | DOAJ |
| issn | 1745-6215 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj-art-16c800b542e34d73bf5d5a4879ed56932025-08-20T02:50:02ZengBMCTrials1745-62152024-09-0125111210.1186/s13063-024-08496-wOPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trialLaetitia Hattingh0Melissa T. Baysari1Holly Foot2Tin Fei Sim3Gerben Keijzers4Mark Morgan5Ian Scott6Richard Norman7Faith Yong8Barbara Mullan9Claire Jackson10Leslie E. Oldfield11Elizabeth Manias12Allied Health Research, Gold Coast HealthBiomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of SydneySchool of Pharmacy, The University of QueenslandCurtin Medical School, Curtin UniversityEmergency Department, Gold Coast HealthFaculty of Health Sciences and Medicine, Bond UniversityMetro South Digital Health and Informatics, Princess Alexandra HospitalSchool of Population Health, Curtin UniversityRural Clinical School, Faculty of Medicine, The University of QueenslandSchool of Population Health, Curtin UniversityGeneral Practice and Primary Care Reform, The University of QueenslandSchool of Pharmacy, The University of QueenslandSchool of Nursing and Midwifery, Monash UniversityAbstract Background General practitioners (GP) and community pharmacists need information about hospital discharge patients’ medicines to continue their management in the community. This necessitates effective communication, collaboration, and reliable information-sharing. However, such handover is inconsistent, and whilst digital systems are in place to transfer information at transitions of care, these systems are passive and clinicians are not prompted about patients’ transitions. There are also gaps in communication between community pharmacists and GPs. These issues impact patient safety, leading to hospital readmissions and increased healthcare costs. Methods A three-phased, multi-method study design is planned to trial a multifaceted intervention to reduce 30-day hospital readmissions. Phase 1 is the co-design of the intervention with stakeholders and end-users; phase 2 is the development of the intervention; phase 3 is a stepped wedge cluster randomised controlled trial with 20 clusters (community pharmacies). Expected intervention components will be a hospital pharmacist navigator, primary care medication management review services, and a digital solution for information sharing. Phase 3 will recruit 10 patients per pharmacy cluster/month to achieve a sample size of 2200 patients powered to detect a 5% absolute reduction in unplanned readmissions from 10% in the control group to 5% in the intervention at 30 days. The randomisation and intervention will occur at the level of the patient’s nominated community pharmacy. Primary analysis will be a comparison of 30-day medication-related hospital readmissions between intervention and control clusters using a mixed effects Poisson regression model with a random effect for cluster (pharmacy) and a fixed effect for each step to account for secular trends. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry: ACTRN12624000480583p , registered 19 April 2024.https://doi.org/10.1186/s13063-024-08496-wMedicine handoverTransition of careHospital dischargeMedication-related harmCommunity pharmacy |
| spellingShingle | Laetitia Hattingh Melissa T. Baysari Holly Foot Tin Fei Sim Gerben Keijzers Mark Morgan Ian Scott Richard Norman Faith Yong Barbara Mullan Claire Jackson Leslie E. Oldfield Elizabeth Manias OPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial Trials Medicine handover Transition of care Hospital discharge Medication-related harm Community pharmacy |
| title | OPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial |
| title_full | OPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial |
| title_fullStr | OPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial |
| title_full_unstemmed | OPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial |
| title_short | OPTimising MEDicine information handover after Discharge (OPTMED-D): protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial |
| title_sort | optimising medicine information handover after discharge optmed d protocol for development of a multifaceted intervention and stepped wedge cluster randomised controlled trial |
| topic | Medicine handover Transition of care Hospital discharge Medication-related harm Community pharmacy |
| url | https://doi.org/10.1186/s13063-024-08496-w |
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