Intervention fidelity and process outcomes of the IMMENSE study, a pharmacist‐led interdisciplinary intervention to improve medication safety in older hospitalized patients.

What is known and Objective: The majority of hospitalized older patients experience medication‐related problems (MRPs), and there is a call for interventions to solve MRPs and improve clinical outcomes like medical visits. The IMMENSE study is a randomized controlled trial investigating the impact o...

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Published in:Journal of Clinical Pharmacy & Therapeutics Vol. 47; no. 5; pp. 619 - 628
Main Authors: Johansen, Jeanette Schultz, Halvorsen, Kjell H., Havnes, Kjerstin, Wetting, Hilde Ljones, Svendsen, Kristian, Garcia, Beate Hennie
Format: research tables/charts Journal Article
Published: Wiley-Blackwell May2022
Online Access:View this record in EBSCOhost
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      dt: May2022
      vid: 47
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jcpt.13581
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        atl: Intervention fidelity and process outcomes of the IMMENSE study, a pharmacist‐led interdisciplinary intervention to improve medication safety in older hospitalized patients.
      aug:
        au:
          Johansen, Jeanette Schultz
          Halvorsen, Kjell H.
          Havnes, Kjerstin
          Wetting, Hilde Ljones
          Svendsen, Kristian
          Garcia, Beate Hennie
        affil: UiT The Arctic University of Norway, Tromsø, Norway
      sug:
        subj:
          Hospitalization of Older Persons
          Medication Management
          Multidisciplinary Care Team
          Program Evaluation
          Human
          Secondary Analysis
          Medication Reconciliation
          Medication Review
          Counseling
      ab: What is known and Objective: The majority of hospitalized older patients experience medication‐related problems (MRPs), and there is a call for interventions to solve MRPs and improve clinical outcomes like medical visits. The IMMENSE study is a randomized controlled trial investigating the impact of a pharmacist‐led interdisciplinary intervention on emergency medical visits. Its multistep intervention is based on the integrated medicines management methodology and includes a follow‐up step with primary care. This study aims to describe how the intervention in the IMMENSE study was delivered and its process outcomes. Methods: The study includes the 221 intervention patients in the per‐protocol group of the IMMENSE study. Both intervention delivery, reasons for not performing interventions and process outcomes were registered daily by the study pharmacists in a Microsoft Access® database. Process outcomes were medication discrepancies, MRPs and how the team solved these. Results and discussion: A total of 121 (54.8%) patients received all intervention steps if appropriate. All patients received medication reconciliation (MedRec) and medication Review (MedRev) (step 1 and 2), while between 10% and 20% of patients were missed for medication list in discharge summary (step 3), patient counselling (step 4), or communication with general practitioner and nurse (step 5). A total of 437 discrepancies were identified in 159 (71.9%) patients during MedRec, and 1042 MRPs were identified in 209 (94.6%) patients during MedRev. Of these, 292 (66.8%) and 700 (67.2%), respectively, were communicated to and solved by the interdisciplinary team during the hospital stay. What is new and Conclusion: The fidelity of the single steps of the intervention was high even though only about half of the patients received all intervention steps. The impact of the intervention may be influenced by not implementing all steps in all patients, but the many discrepancies and MRPs identified and solved for the patients could explain a potential effect of the IMMENSE study.
      pubtype: Academic Journal
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        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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