Improving Pharmacological Transition of Palliative Care Patients From Inpatient to Outpatient Care

University Hospital Muenster200 enrolled

Overview

The transition of palliative care patients from inpatient to outpatient care is aimed to be improved through structured pharmaceutical discharge management by a trained pharmacist. This data will be compared with retrospective cases.

As part of a prospective observational study with a retrospective comparison group, a pharmacist should, on request, check the discharge medication planned by the primary care physicians before discharge and discuss it with the various colleagues providing (follow-up) care. In addition, the availability in the outpatient "medicine cabinet" and the possibility of prescribing by the responsible GPs (by telephone) should be checked in advance. In addition, longitudinal focus groups with relevant stakeholders are to be conducted to collect quantitative data as well as qualitative data on the views of those providing and receiving treatment. There will be cooperation with the Specialized Outpatient Palliative Care Service Muenster to ensure sufficient case numbers and a low rate of missing values through partial use of the standard care data from the "Information System Palliative Care" (ISPC) program they use.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

200

Conditions

Cancer Heart Failure COPD

Interventions

Structured pharmaceutical discharge managementOTHER

These patients will receive structured pharmaceutical discharge management from inpatient to outpatient care.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: All individual indications for general and specialised palliative care as part of routine clinical practice (e.g.): * advanced, malignant tumour disease * advanced, chronic obstructive pulmonary disease * Patients with advanced disease and limited life expectancy (approx. 12 months) Further care in the SOPC Muenster (prospective data) Sufficient understanding of the German language to be able to understand the information and consent form Exclusion Criteria: Impossibility of understanding the information and declaration of consent.

Locations (1)

University Hospital Muenster

Münster, North Rhine-Westphalia, Germany

RECRUITING

Outcomes

Primary Outcomes

(I) Drug-related problems

(I) Number of drug-related problems at the time of discharge according to PCNE (comparison of prospective, actually proposed changes vs. hypothetical number and type of problems at the time of discharge in the retrospective comparison cohort)

Time frame: 12 months

(II) Drug-related problems

(II) Type of drug-related problems at the time of discharge according to PCNE (comparison of prospective, actually proposed changes vs. hypothetical number and type of problems at the time of discharge in the retrospective comparison cohort)

Time frame: 12 months

Secondary Outcomes

Number of contacts

Number of contacts made by patients/relatives with SOPC within 7 days of discharge

Time frame: 12 months

Number of readmissions / visits

Number of readmissions and / or visits to the emergency department within 7 and 14 days after hospital discharge

Time frame: 12 months

Symptom burden

Change in patient symptom burden via Integrated Palliative Care Outcome. The total scores using the IPOS can range between 0 and 68 points. The higher the score, the more severe are the patient's symptoms. Scale after 3, 7 and 14 days compared to day 0 (discharge date)

Time frame: 12 months

(I) Medication changes

(I) Number of medication changes suggested by pharmacists according to PCNE

Time frame: 12 months

Adoption rate

Adoption rate by the primary care physicians of the pharmacist's proposed changes after PCNE (see primary endpoint)

Central Contacts

Christoph Klaas, Dr. rer. nat.

CONTACT

+49 251 83-48843 christoph.klaas@ukmuenster.de

Data from ClinicalTrials.gov

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