NCT02999412: MedBridge

Medication Reviews Bridging Healthcare: a Cluster-randomised Crossover Trial

Completed NA Last updated 25 June 2021

What this trial tests

NA trial testing Comprehensive medication review in Medication Review in 2,637 participants. Completed in 3 June 2020.

Timeline

6 February 2017

Primary endpoint
11 December 2019

3 June 2020

Quick facts

Lead sponsor	Uppsala County Council, Sweden
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	crossover
Masking	single
Primary purpose	health services research
Enrollment	2,637
Start date	6 February 2017
Primary completion	11 December 2019
Estimated completion	3 June 2020
Sites	4 locations across Sweden

Drugs / interventions tested

• Comprehensive medication review
• Comprehensive medication review with active follow-up
• Usual Care

Conditions studied

• Medication Review — all drugs for Medication Review →

Sponsor

Uppsala County Council, Sweden

Who can join

65 and older, any sex, with Medication Review. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Background: Mismanaged prescribing and use of medication among elderly puts major pressure on current healthcare systems. Performing a medication review, a structured critical examination of a patient's medications, during hospital stay with active follow-up into primary care could optimise treatment benefit and minimise harm. However, a lack of high quality evidence inhibits widespread implementation. This manuscript describes the rationale and design of a pragmatic cluster-randomised, crossover trial to fulfil this need for evidence.

Aim: To study the effects of hospital-initiated comprehensive medication reviews, including active follow-up, on elderly patients' healthcare utilisation compared to 1) usual care and 2) solely hospital based reviews.

Design: Multicentre, three-treatment, replicated, cluster-randomised, crossover trial.

Setting: 8 wards with a multidisciplinary team within 4 hospitals in 3 Swedish counties.

Participants: Patients aged 65 years or older, admitted to one of the study wards. Exclusion criteria: Palliative stage; residing in other than the hospital's county; medication review within the last 30 days; one-day admission.

Interventions: 1, comprehensive medication review during hospital stay; 2, same as 1 with the addition of active follow-up into primary care; 3, usual care.

Primary outcome measure: Incidence of unplanned hospital visits during a 12-month follow-up period.

Data collection and analyses: Extraction and collection from the counties' medical record system into a GCP compliant electronic data capture system. Intention-to-treat-analyses using log-linear Poisson generalized linear mixed models and frailty models.

Relevance: This study has a high potential to show a reduction in elderly patients' morbidity, contributing to more sustainable healthcare in the long run.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

1. Reducing medication errors for adults in hospital settings.
   Ciapponi A, Fernandez Nievas SE, Seijo M, Rodríguez MB, et al · · 2021 · cited 41× · PMID 34822165 · DOI 10.1002/14651858.cd009985.pub2
2. Incorrect Trial Registration Identifier.
   · 2022 · PMID 35380650 · DOI 10.1001/jamanetworkopen.2022.9745