Deprescribing for Older Adults After Hospital Discharge in Home Health Care

University of Rochester5 enrolled

Overview

The purpose of this study is to examine the feasibility of providing a medication optimization program to improve patient health outcomes during the transition from hospital to home. This is because the period after hospital discharge is critical to long-term recovery, overall quality of life, and prevention of future hospitalizations.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Polypharmacy

Interventions

HomeMedBEHAVIORAL

The HomeMed intervention is a multidisciplinary deprescribing intervention including home visits and team-based telehealth communication (optional). The components included in the HomeMed intervention include home medication review, medication education and provision of tools to assist the patients with medication administration, assessment of deprescribing targets by a trained geriatric clinical pharmacist, communication with the patient's treating primary care provider about deprescribing recommendation, deprescribing implementation (optional), and deprescribing monitoring (optional). Depending on the patient's treating primary care provider's decision on deprescribing and monitoring, the number of home visits ranges from a minimum of three to more with the entire duration of the intervention ranging from approximately 1 to 3 months.

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Patient Inclusion Criteria: * 65 years of age and older * currently hospitalized or having been hospitalized in the previous 2 weeks * having a discharge disposition of home with a referral to receive HHC services from URMHC, or currently receiving HHC services from URMHC * taking more than 10 regular medications daily * having a primary care provider who is in the URMC system * Ability to self-consent * English-speaking Patient Exclusion Criteria: * end-of-life prognosis in the following 6 months * currently receiving hospice care, end-of-life care, or palliative care * conditions that impact the receipt of the intervention, such as severe cognitive impairment that interferes with the subject's ability to communicate with interventionists; * substantial difficulties in hearing, vision, and verbal expression that disable the participant from communicating effectively while receiving the HomeMed intervention

Locations (1)

University of Rochester Medical Center

Rochester, New York, United States

Outcomes

Primary Outcomes

mean time spent on intervention

Time frame: 3 months

number of participants who complete a post intervention survey about feasibility

Time frame: 3 months

Percentage of participants undergoing deprescribing

Time frame: 3 months

Percentage of intervention adherence indicators checked

Time frame: 3 months

Percentage of patients who improve in ability to do things that are important before and after intervention

Time frame: 3 months

Total number of medications used per participant

Time frame: 3 months

Percentage of patients who report a reduction in medication burden

Medication burden will be reported by phone or survey.

Time frame: 3 months

Percentage of participants who report a reduction in medication side effect

Side effects will be collected by phone.

Time frame: 3 months

Data from ClinicalTrials.gov

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