Medication Reviews Bridging Healthcare (MedBridge): Study protocol for a pragmatic cluster-randomised crossover trial

Kempen, Thomas; Bertilsson, Maria; Lindner, Karl‐Johan; Sulku, Johanna; Nielsen, Elisabet I.; Högberg, Angelica; Vikerfors, Tomas; Melhus, Håkan; Gillespie, Ulrika

doi:10.1016/j.cct.2017.07.019

Cited by 16 publications

(21 citation statements)

References 15 publications

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“…This study identified multiple facilitators and barriers, grouped in six main themes, for performing CMRs and postdischarge follow-up by multiprofessional teams in older hospitalised patients. These factors were derived from interviews with physicians and pharmacists, as part of a process evaluation of the MedBridge trial [11].…”

Section: Discussionmentioning

confidence: 99%

“…This study was performed in the context of the MedBridge trial, which takes place at in total eight wards within four hospitals in Sweden: the hospitals in Enköping, Gävle, Uppsala and Västerås [11]. The wards differ in terms of medical specialty: geriatric, internal medicine, stroke, diabetes and nephrology.…”

Section: Study Contextmentioning

confidence: 99%

“…A discussion guide in Swedish was developed in relation to the intervention components within the MedBridge trial [11] and informed by the concepts of interprofessional collaboration by D'Amour et al [29]. The topics were working processes, resources, competences, medicationrelated problems, intervention effects and collaboration (Appendix 1a).…”

Section: Data Generationmentioning

confidence: 99%

“…Usual care without a clinical pharmacist involved Fig. 1 Interventions within the Medication Reviews Bridging Healthcare (MedBridge) trial per study group [11]. CMR, comprehensive medication review; GP, general practitioner…”

Section: Control: Usual Care (N=895)mentioning

confidence: 99%

“…To fulfil this need, the Medication Reviews Bridging Healthcare (MedBridge; www.clinicaltrials.gov: NCT02986425) trial is currently being performed at four hospitals in Sweden [11]. This RCT aims to study the effects of two interventions compared with usual care on older patients' health outcomes: (1) a CMR by a ward-based pharmacist in collaboration with the physician and patient during hospital stay; and (2) the same as the first intervention, with the addition of a follow-up phone call by the pharmacist 2-7 days and 1-2 months after hospital discharge, and a medication referral to the patient's general practitioner (GP) upon discharge if necessary.…”

Section: Introductionmentioning

confidence: 99%

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Facilitators and barriers for performing comprehensive medication reviews and follow-up by multiprofessional teams in older hospitalised patients

Kempen

Kälvemark

Sawires

et al. 2020

Eur J Clin Pharmacol

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Purpose There is a lack of knowledge about factors that influence the performance of comprehensive medication reviews (CMRs) by multiprofessional teams in hospital practice. This study aimed to explore the facilitators and barriers for performing CMRs and post-discharge follow-up in older hospitalised patients from the healthcare professional perspective. Methods Physicians and ward-based pharmacists were recruited from an ongoing trial at four hospitals in Sweden. Semistructured interviews were conducted with 16 physicians and 7 pharmacists. Interview topics were working processes, resources, competences, medication-related problems, intervention effects and collaboration. The interviews were audio-recorded, transcribed verbatim and thematically analysed using the Consolidated Framework for Implementation Research (CFIR). Identified subthemes were categorised as facilitators or barriers and grouped into overarching main themes. Results In total, 21 facilitators and 25 barriers were identified across all CFIR domains and grouped in 6 main themes: (a) CMRs and follow-up are needed, but not in all patients; (b) there is a general belief in positive effects; (c) lack of resources is an issue, although the performance of CMRs may save time; (d) pharmacists' knowledge and skills are valuable, but they need more clinical competence; (e) compatibility with hospital practice is challenging, and roles and responsibilities are unclear and (f) personal contact at the ward is essential for physician-pharmacist collaboration. Conclusion Multiple facilitators and barriers for performing CMRs and post-discharge follow-up in older hospitalised patients exist. These factors should be addressed in future initiatives with similar interventions by multiprofessional teams to ensure successful implementation and performance in hospital practice.

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Section: Discussionmentioning

confidence: 99%

Section: Study Contextmentioning

confidence: 99%

Section: Data Generationmentioning

confidence: 99%

Section: Control: Usual Care (N=895)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Facilitators and barriers for performing comprehensive medication reviews and follow-up by multiprofessional teams in older hospitalised patients

Kempen

Kälvemark

Sawires

et al. 2020

Eur J Clin Pharmacol

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Effects of Hospital-Based Comprehensive Medication Reviews Including Postdischarge Follow-up on Older Patients’ Use of Health Care

Kempen

Bertilsson²,

Hadziosmanovic³

et al. 2021

JAMA Netw Open

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IMPORTANCE Suboptimal use of medications is a leading cause of health care-related harm. Medication reviews improve medication use, but evidence of the possible benefit of inpatient medication review for hard clinical outcomes after discharge is scarce. OBJECTIVE To study the effects of hospital-based comprehensive medication reviews (CMRs), including postdischarge follow-up of older patients' use of health care resources, compared with only hospital-based reviews and usual care. DESIGN, SETTING, AND PARTICIPANTSThe Medication Reviews Bridging Healthcare trial is a cluster randomized crossover trial that was conducted in 8 wards with multiprofessional teams at 4

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Medication review in hospitalised patients to reduce morbidity and mortality

Bülow

Clausen

Lundh

et al. 2023

Cochrane Database of Systematic Reviews

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Medication Reviews Bridging Healthcare (MedBridge): Study protocol for a pragmatic cluster-randomised crossover trial

Abstract: Kempen, T et al 2017 Medication Reviews Bridging Healthcare

Cited by 16 publications

References 15 publications

Facilitators and barriers for performing comprehensive medication reviews and follow-up by multiprofessional teams in older hospitalised patients

Facilitators and barriers for performing comprehensive medication reviews and follow-up by multiprofessional teams in older hospitalised patients

Effects of Hospital-Based Comprehensive Medication Reviews Including Postdischarge Follow-up on Older Patients’ Use of Health Care

Medication review in hospitalised patients to reduce morbidity and mortality

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