From hospitalisation to primary care: integrative model of clinical pharmacy with patients implanted with a PICC line—research protocol for a prospective before–after study

Abstract

IntroductionClinical pharmacy improves patient safety and secures drug management using information, education and good clinical practices. However, medical device management is still unexplored, and proof of effectiveness is needed. A PICC line (peripherally inserted central catheter) is a medical device for infusion. It accesses the central venous system after being implanted in a peripheral vein. However, complications after implantation often interfere with smooth execution of the treatment. We hypothesise that clinical pharmacy for medical devices could be as effective as clinical pharmacy for medications. The main objective is to assess the effectiveness of clinical pharmacy activities on the complication rate after PICC line implantation.Methods and analysisThis is a before–after prospective study. The study will begin with an observational period without clinical pharmacy activities, followed by an interventional period where pharmacists will intervene on drug and medical device management and provide personalised follow-up and advice. Sixty-nine adult patients will be recruited in each 6-month period from all traditional care units. The main inclusion criteria will be the implantation of a PICC line. The primary outcome is the decrease in the number of complications per patient and per month. Secondary outcomes are the consultation and hospital readmission rates, the acceptance rate of pharmaceutical interventions, the patients’ quality of life, the direct hospital induced or avoided costs and the participants’ satisfaction. Data will be collected using case report forms during hospitalisation and telephone follow-up after discharge. The analysis will compare these criteria during the two periods.Ethics and disseminationThe study has received the approval of our Ethics Committee (Clermont-Ferrand Southeast VI, France, number AU1586). Results will be made available to the patients or their caregivers, the sponsor and other researchers when asked, as described in the consent form.Trial registration numberNCT04359056.

Application of Nursing Intervention Based on Intelligent Grip Strength System in Patients with Tumor PICC: A Case-Control Study on Promoting Functional Exercise and Quality of Life

“…With the wide application of the Internet, the health management model based on mobile phone application software has been developed rapidly. Studies have shown that the health management model based on mobile phone application software can improve the compliance of postoperative functional exercise and promote the rehabilitation of breast cancer patients [13]. In this study, with the intelligent grip ball as the carrier, integrating the advantages of grip movement and hand functional exercise, the mobile phone application software "Intelligent grip strength system" was designed to decline the functional exercise compliance of PICC patients, promote functional exercise, improve the quality of life, and reduce the incidence of catheter-related thrombosis.…”

Pharmaceutical Analysis of Peripherally Inserted Central Catheter Requests Increases the Use of Single-Lumen Catheters: A Prospective Pilot Study

“…This could be due to the pilot design of the study and its relative associated lack of power and more studies should be conducted to confirm this trend. 21 Considering the subgroup analysis including all PICCs from both control and in-tervention groups, single-lumen PICCs showed a significant reduction in overall complications and occlusions, whereas no significant differences were reported for CRBSI and DVT. The complication risk was higher with the double-lumen PICCs performing a multivariate analysis adjusted for sex, age, indication, and PICC line duration (OR, 3.83; 95% CI, 1.46-10.07, P = 0.007).…”

“…Although our study showed a significant reduction in the use of double-lumen PICCs after the CP intervention, the number of complications was lower with the pharmacist intervention although it was not significant. This could be due to the pilot design of the study and its relative associated lack of power and more studies should be conducted to confirm this trend 21 . Considering the subgroup analysis including all PICCs from both control and intervention groups, single-lumen PICCs showed a significant reduction in overall complications and occlusions, whereas no significant differences were reported for CRBSI and DVT.…”