Comprehensive Medication Monitoring on Heart Failure Patient Outcomes
| Status: | Withdrawn |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/27/2019 |
| Start Date: | September 2018 |
| End Date: | January 21, 2019 |
A Pilot Prospective, Randomized Controlled Trial Assessing the Impact of Clinical Decision Support Using Comprehensive Medication Monitoring on Heart Failure Patient Outcomes
The purpose of this study is to evaluate the clinical utility of comprehensive medication
monitoring using the Patient Medication Profile to improve heart failure patient medication
therapy and associated outcomes relative to usual care in a hospital setting.
monitoring using the Patient Medication Profile to improve heart failure patient medication
therapy and associated outcomes relative to usual care in a hospital setting.
Congestive heart failure has an exceptionally high rate of hospital admission and is
responsible for more re-admissions (23.5% at 30 days) in the United States than the 2nd and
3rd leading causes combined. Inadequate medication reconciliation both on admission and
discharge from the hospital is a significant cause of medical error. In one study of
cardiovascular patients, 44% believed they were taking a medication they were not, and 96%
were unable to recall at least one medication they were taking. In the same study patients
omitted on average 6.8 medications from their medication list. Medication optimization
through improved adherence and reconciled medical records has been postulated to
significantly improve admission and 30-day hospital readmission rates.
Sano has developed a blood-based comprehensive medication monitoring tool that identifies and
quantitates 235 prescription drugs and drug metabolites. It does not detect illicit drugs.
This tool, which produces an output report designated the 'Patient Medication Profile', is
designed to be used with clinical decision support to improve medication adherence, reduce
medication errors, and optimize medication therapy. For heart failure patients, the
investigators hypothesize that deploying the Patient Medication Profile with clinical
decision support at key points of treatment intervention will A) improve medication
adherence, B) identify and reconcile significant discrepancies in the medication list, C)
result in reduced hospital admissions, and D) result in better overall patient outcomes.
These outcome expectations are relative to usual care for heart failure patients.
responsible for more re-admissions (23.5% at 30 days) in the United States than the 2nd and
3rd leading causes combined. Inadequate medication reconciliation both on admission and
discharge from the hospital is a significant cause of medical error. In one study of
cardiovascular patients, 44% believed they were taking a medication they were not, and 96%
were unable to recall at least one medication they were taking. In the same study patients
omitted on average 6.8 medications from their medication list. Medication optimization
through improved adherence and reconciled medical records has been postulated to
significantly improve admission and 30-day hospital readmission rates.
Sano has developed a blood-based comprehensive medication monitoring tool that identifies and
quantitates 235 prescription drugs and drug metabolites. It does not detect illicit drugs.
This tool, which produces an output report designated the 'Patient Medication Profile', is
designed to be used with clinical decision support to improve medication adherence, reduce
medication errors, and optimize medication therapy. For heart failure patients, the
investigators hypothesize that deploying the Patient Medication Profile with clinical
decision support at key points of treatment intervention will A) improve medication
adherence, B) identify and reconcile significant discrepancies in the medication list, C)
result in reduced hospital admissions, and D) result in better overall patient outcomes.
These outcome expectations are relative to usual care for heart failure patients.
Inclusion Criteria:
- Patients must have a regularly scheduled visit to a University of Pittsburgh Medical
Center (UPMC) cardiology clinic in Oakland
- Patients must have Heart Failure with Reduced Ejection Fraction (≤40%)
- Patients have admitted to UPMC hospital facility between one and five times in past 12
months
- Patients must be able to provide informed consent for present study
- Patient age > 18 years
Exclusion Criteria:
- Enrolled in Hospice
- Patient on home inotrope (Dobutamine or milrinone)
- World Health Organization (WHO) Group 1 or Group 5 pulmonary hypertension
- Patient with current ventricular assist device (VAD)
- Not able to communicate in English
We found this trial at
1
site
Pittsburgh, Pennsylvania 15232
Principal Investigator: Ravi Ramani, MD
Phone: 412-647-4463
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