Arid
DOI10.1111/1475-6773.12176
A Randomized, Controlled Pragmatic Trial of Telephonic Medication Therapy Management to Reduce Hospitalization in Home Health Patients
Zillich, Alan J.1,2; Snyder, Margie E.3; Frail, Caitlin K.4; Lewis, Julie L.5; Deshotels, Donny5; Dunham, Patrick6; Jaynes, Heather A.3; Sutherland, Jason M.7
通讯作者Zillich, Alan J.
来源期刊HEALTH SERVICES RESEARCH
ISSN0017-9124
EISSN1475-6773
出版年2014
卷号49期号:5页码:1537-1554
英文摘要

Objective. To evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing hospitalizations among home health patients.


Setting. Forty randomly selected, geographically diverse home health care centers in the United States.


Design. Two-stage, randomized, controlled trial with 60-day follow-up. All Medicare-insured home health care patients were eligible to participate. Twenty-eight consecutive patients within each care center were recruited and randomized to usual care or MTM intervention. The MTM intervention consisted of the following: (1) initial phone call by a pharmacy technician to verify active medications; (2) pharmacist-provided medication regimen review by telephone; and (3) follow-up pharmacist phone calls at day seven and as needed for 30 days. The primary outcome was 60-day all-cause hospitalization.


Data Collection. Data were collected from in-home nursing assessments using the OASIS-C. Multivariate logistic regression modeled the effect of the MTM intervention on the probability of hospitalization while adjusting for patients’ baseline risk of hospitalization, number of medications taken daily, and other OASIS-C data elements.


Principal Findings. A total of 895 patients (intervention n = 415, control n = 480) were block-randomized to the intervention or usual care. There was no significant difference in the 60-day probability of hospitalization between the MTM intervention and control groups (Adjusted OR: 1.26, 95 percent CI: 0.89-1.77, p = .19). For patients within the lowest baseline risk quartile (n = 232), the intervention group was three times more likely to remain out of the hospital at 60 days (Adjusted OR: 3.79, 95 percent CI: 1.35-10.57, p = .01) compared to the usual care group.


Conclusions. This MTM intervention may not be effective for all home health patients; however, for those patients with the lowest-risk profile, the MTM intervention prevented patients from being hospitalized at 60 days.


英文关键词Clinical trial medication therapy management home health care hospitalization outcomes
类型Article
语种英语
国家USA ; Canada
收录类别SCI-E ; SSCI
WOS记录号WOS:000343006400008
WOS关键词ECONOMIC OUTCOMES ; ASHEVILLE-PROJECT ; PROGRAM ; BENEFICIARIES ; HYPERTENSION ; PHARMACISTS ; EXPERIENCE ; ADHERENCE ; SAFETY ; IMPACT
WOS类目Health Care Sciences & Services ; Health Policy & Services
WOS研究方向Health Care Sciences & Services
资源类型期刊论文
条目标识符http://119.78.100.177/qdio/handle/2XILL650/182380
作者单位1.Purdue Univ, Coll Pharm, Purdue Pharm Programs, Dept Pharm Practice, Indianapolis, IN 46202 USA;
2.Roudebush VA Med Ctr, Ctr Hlth Informat & Commun, Indianapolis, IN 46202 USA;
3.Purdue Univ, Coll Pharm, Dept Pharm Practice, Indianapolis, IN 46202 USA;
4.Univ Minnesota, Coll Pharm, Dept Pharmaceut Care & Hlth Syst, Minneapolis, MN 55455 USA;
5.Amedisys Inc, Baton Rouge, LA USA;
6.HealthStat Rx, Smyrna, GA USA;
7.Univ British Columbia, Ctr Hlth Serv Res & Policy, Vancouver, BC V5Z 1M9, Canada
推荐引用方式
GB/T 7714
Zillich, Alan J.,Snyder, Margie E.,Frail, Caitlin K.,et al. A Randomized, Controlled Pragmatic Trial of Telephonic Medication Therapy Management to Reduce Hospitalization in Home Health Patients[J],2014,49(5):1537-1554.
APA Zillich, Alan J..,Snyder, Margie E..,Frail, Caitlin K..,Lewis, Julie L..,Deshotels, Donny.,...&Sutherland, Jason M..(2014).A Randomized, Controlled Pragmatic Trial of Telephonic Medication Therapy Management to Reduce Hospitalization in Home Health Patients.HEALTH SERVICES RESEARCH,49(5),1537-1554.
MLA Zillich, Alan J.,et al."A Randomized, Controlled Pragmatic Trial of Telephonic Medication Therapy Management to Reduce Hospitalization in Home Health Patients".HEALTH SERVICES RESEARCH 49.5(2014):1537-1554.
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