Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study design

Introduction The ‘emergency department (ED) pharmacist’ is an integrated part of the ED interdisciplinary team in many countries, which have shown to improve medication safety and reduce costs related to hospitalisations. In Norway, few EDs are equipped with ED pharmacists, and research describing e...

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Main Authors: Torbjørn Wisløff, Eirik Hugaas Ofstad, Elin C Lehnbom, Renate Elenjord, Renata Vesela, Tine Johnsgård, Birgitte Zahl-Holmstad, Torstein Risør, Lars Røslie, Ole Magnus Filseth, Per-Christian Valle, Kristian Svendsen, Hanne Mathilde Frøyshov, Beate H Garcia
Format: Article
Language:English
Published: BMJ Publishing Group 2021-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/11/e049645.full
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author Torbjørn Wisløff
Eirik Hugaas Ofstad
Elin C Lehnbom
Renate Elenjord
Renata Vesela
Tine Johnsgård
Birgitte Zahl-Holmstad
Torstein Risør
Lars Røslie
Ole Magnus Filseth
Per-Christian Valle
Kristian Svendsen
Hanne Mathilde Frøyshov
Beate H Garcia
author_facet Torbjørn Wisløff
Eirik Hugaas Ofstad
Elin C Lehnbom
Renate Elenjord
Renata Vesela
Tine Johnsgård
Birgitte Zahl-Holmstad
Torstein Risør
Lars Røslie
Ole Magnus Filseth
Per-Christian Valle
Kristian Svendsen
Hanne Mathilde Frøyshov
Beate H Garcia
author_sort Torbjørn Wisløff
collection DOAJ
description Introduction The ‘emergency department (ED) pharmacist’ is an integrated part of the ED interdisciplinary team in many countries, which have shown to improve medication safety and reduce costs related to hospitalisations. In Norway, few EDs are equipped with ED pharmacists, and research describing effects on patients has not been conducted. The aim of this study is to investigate the impact of introducing clinical pharmacists to the interdisciplinary ED team. In this multicentre study, the intervention will be pragmatically implemented in the regular operation of three EDs in Northern Norway; Tromsø, Bodø and Harstad. Clinical pharmacists will work as an integrated part of the ED team, providing pharmaceutical care services such as medication reconciliation, review and/or counselling. The primary endpoint is ‘time in hospital during 30 days after admission to the ED’, combining (1) time in ED, (2) time in hospital (if hospitalised) and (3) time in ED and/or hospital if re-hospitalised during 30 days after admission. Secondary endpoints include time to rehospitalisation, length of stay in ED and hospital and rehospitalisation and mortality rates.Methods and analysis We will apply a non-randomised stepped-wedge study design, where we in a staggered way implement the ED pharmacists in all three EDs after a 3, 6 and 9 months control period, respectively. We will include all patients going through the three EDs during the 12-month study period. Patient data will be collected retrospectively from national data registries, the hospital system and from patient records.Ethics and dissemination The Regional Committee for Medical and Health Research Ethics and Local Patient Protection Officers in all hospitals have approved the study. Patients will be informed about the ongoing study on a general basis with ads on posters and flyers.Trial registration number NCT04722588.
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spelling doaj-art-1ad6d919342e4ae1a4e4dcb46d32869c2025-08-20T02:18:46ZengBMJ Publishing GroupBMJ Open2044-60552021-11-01111110.1136/bmjopen-2021-049645Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study designTorbjørn Wisløff0Eirik Hugaas Ofstad1Elin C Lehnbom2Renate Elenjord3Renata Vesela4Tine Johnsgård5Birgitte Zahl-Holmstad6Torstein Risør7Lars Røslie8Ole Magnus Filseth9Per-Christian Valle10Kristian Svendsen11Hanne Mathilde Frøyshov12Beate H Garcia135 Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway4 Department of Medicine, Nordland Hospital Trust, Bodo, Norway2 Department of Pharmacy, UiT The Arctic University of Norway, Tromso, Norway1 Hospital Pharmacy of North Norway Trust, Tromso, Norway1 Hospital Pharmacy of North Norway Trust, Tromso, Norway1 Hospital Pharmacy of North Norway Trust, Tromso, Norway1 Hospital Pharmacy of North Norway Trust, Tromso, Norway5 Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway7 Department of Emergency Medicine, University Hospital of North Norway Trust, Tromso, Norway7 Department of Emergency Medicine, University Hospital of North Norway Trust, Tromso, Norway8 Department of Emergency Medicine, University Hospital of North Norway Trust, Harstad, Norway2 Department of Pharmacy, UiT The Arctic University of Norway, Tromso, Norway8 Department of Emergency Medicine, University Hospital of North Norway Trust, Harstad, Norway1 Hospital Pharmacy of North Norway Trust, Tromso, NorwayIntroduction The ‘emergency department (ED) pharmacist’ is an integrated part of the ED interdisciplinary team in many countries, which have shown to improve medication safety and reduce costs related to hospitalisations. In Norway, few EDs are equipped with ED pharmacists, and research describing effects on patients has not been conducted. The aim of this study is to investigate the impact of introducing clinical pharmacists to the interdisciplinary ED team. In this multicentre study, the intervention will be pragmatically implemented in the regular operation of three EDs in Northern Norway; Tromsø, Bodø and Harstad. Clinical pharmacists will work as an integrated part of the ED team, providing pharmaceutical care services such as medication reconciliation, review and/or counselling. The primary endpoint is ‘time in hospital during 30 days after admission to the ED’, combining (1) time in ED, (2) time in hospital (if hospitalised) and (3) time in ED and/or hospital if re-hospitalised during 30 days after admission. Secondary endpoints include time to rehospitalisation, length of stay in ED and hospital and rehospitalisation and mortality rates.Methods and analysis We will apply a non-randomised stepped-wedge study design, where we in a staggered way implement the ED pharmacists in all three EDs after a 3, 6 and 9 months control period, respectively. We will include all patients going through the three EDs during the 12-month study period. Patient data will be collected retrospectively from national data registries, the hospital system and from patient records.Ethics and dissemination The Regional Committee for Medical and Health Research Ethics and Local Patient Protection Officers in all hospitals have approved the study. Patients will be informed about the ongoing study on a general basis with ads on posters and flyers.Trial registration number NCT04722588.https://bmjopen.bmj.com/content/11/11/e049645.full
spellingShingle Torbjørn Wisløff
Eirik Hugaas Ofstad
Elin C Lehnbom
Renate Elenjord
Renata Vesela
Tine Johnsgård
Birgitte Zahl-Holmstad
Torstein Risør
Lars Røslie
Ole Magnus Filseth
Per-Christian Valle
Kristian Svendsen
Hanne Mathilde Frøyshov
Beate H Garcia
Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study design
BMJ Open
title Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study design
title_full Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study design
title_fullStr Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study design
title_full_unstemmed Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study design
title_short Integrating the clinical pharmacist into the emergency department interdisciplinary team: a study protocol for a multicentre trial applying a non-randomised stepped-wedge study design
title_sort integrating the clinical pharmacist into the emergency department interdisciplinary team a study protocol for a multicentre trial applying a non randomised stepped wedge study design
url https://bmjopen.bmj.com/content/11/11/e049645.full
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