Medication Therapy Management after Hospitalization in CKD: A Randomized Clinical Trial.

Document Type

Article

Publication Date

2-7-2018

Publication Title

Clin J Am Soc Nephrol

Keywords

Acute illness; Chronic; Hospital readmission; Humans; Medication Adherence; Medication Therapy Management; Medication management; Renal Insufficiency; Transitional care; chronic kidney disease; hospitalization

Abstract

BACKGROUND AND OBJECTIVES: CKD is characterized by remarkably high hospitalization and readmission rates. Our study aim was to test a medication therapy management intervention to reduce subsequent acute care utilization.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CKD Medication Intervention Trial was a single-blind (investigators), randomized clinical trial conducted at Providence Health Care in Spokane, Washington. Patients with CKD stages 3-5 not treated by dialysis who were hospitalized for acute illness were recruited. The intervention was designed to improve posthospitalization care by medication therapy management. A pharmacist delivered the intervention as a single home visit within 7 days of discharge. The intervention included these fundamental elements: comprehensive medication review, medication action plan, and a personal medication list. The primary outcome was a composite of acute care utilization (hospital readmissions and emergency department and urgent care visits) for 90 days after hospitalization.

RESULTS: Baseline characteristics of participants (

CONCLUSIONS: Acute care utilization after hospitalization was not reduced by a pharmacist-led medication therapy management intervention at the transition from hospital to home.

Clinical Institute

Kidney & Diabetes

Department

Nephrology

Department

Pharmacy

Department

Nursing

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