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Difficulties with patient recruitement
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The purpose of this study is to determine the benefit of patients using a multidrug blister packs after discharged from an university hospital to their homes.
Typical adherence rates for oral prescription medications are approximately 50-76%. Insufficient adherence causes an increase in morbidity, mortality, and costs, and decreases quality of life of patients. Multidrug blister packs are recommended to improve adherence and are widely used in Switzerland. However, evidence is poor and patient-relevant endpoints are seldom measured. This study was designed to compare patient-relevant outcomes in patients with medication repackaged in multidrug blister packs versus patients with medication dispensed in commercially available packages. Adherence of the intervention group will be monitored electronically and feedback will be given to the patients. The intervention will take place in a study pharmacy. Follow-up visits will take place at the study pharmacy at 3, 6, and 12 months for all patients. Study duration will be 12 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | At hospital discharge, patients of the control group will receive usual care at their community pharmacy. | |
| Electronic Multidrug Blister Pack | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Electronic multidrug blister pack | Device | At hospital discharge, patients will get their prescribed drugs repackaged in an electronic multidrug blister pack with 7x4 cavities. The electronic film affixed on the rear side measures the date and time when a loop is broken, i.e. when a cavity is emptied. Patients will get feedback on their adherence profiles at the community pharmacy. |
| Measure | Description | Time Frame |
|---|---|---|
| Time to rehospitalisation + time to major therapy adjustment | The outcome measure will be assessed at 3, 6, and 12 months. | 12 months |
| Medication Possession Ratio | MPR will be assessed at 3, 6, and 12 months. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Timing and taking adherence according to the electronic monitoring system and through patient self report | Electronic monitoring will be continuous over 12 months. Patient self report will be assessed at 3, 6, and 12 months. | 12 months |
| Quality of life |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kurt E Hersberger, Prof PhD | University of Basel | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Notfallapotheke | Basel | Canton of Basel-City | 4056 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21901694 | Background | Mahtani KR, Heneghan CJ, Glasziou PP, Perera R. Reminder packaging for improving adherence to self-administered long-term medications. Cochrane Database Syst Rev. 2011 Sep 7;(9):CD005025. doi: 10.1002/14651858.CD005025.pub3. | |
| 9467683 | Background | Cramer JA. Enhancing patient compliance in the elderly. Role of packaging aids and monitoring. Drugs Aging. 1998 Jan;12(1):7-15. doi: 10.2165/00002512-199812010-00002. |
| Label | URL |
|---|---|
| Pharmaceutical Care Research Group, University of Basel, Switzerland | View source |
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Quality of life will be assessed at 3, 6, and 12 months. |
| 12 months |
| Patient satisfaction | 12 months |
| 16079372 | Background | Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 Aug 4;353(5):487-97. doi: 10.1056/NEJMra050100. No abstract available. |
| 14998735 | Background | Rosen MI, Rigsby MO, Salahi JT, Ryan CE, Cramer JA. Electronic monitoring and counseling to improve medication adherence. Behav Res Ther. 2004 Apr;42(4):409-22. doi: 10.1016/S0005-7967(03)00149-9. |