Evidence map›Paper›PMID 28408545›Full record

Trial reportBMJ open2017

Reducing Medical Admissions into Hospital through Optimising Medicines (REMAIN HOME) Study: protocol for a stepped-wedge, cluster-randomised trial.

Holly Foot, Christopher Freeman, Karla Hemming, Ian Scott, Ian D Coombes, Ian D Williams, Luke Connelly, Jennifer A Whitty, Nancy Sturman, Sue Kirsa and 4 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Holly FootSchool of Pharmacy, University of Queensland, Brisbane, Queensland, Australia.
Christopher FreemanSchool of Pharmacy, University of Queensland, Brisbane, Queensland, Australia c.freeman4@uq.edu.au.
Karla HemmingDepartment of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK.
Ian ScottDepartment of Internal Medicine and Clinical Epidemiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Ian D CoombesSchool of Pharmacy, University of Queensland, Brisbane, Queensland, Australia.
Ian D WilliamsBrisbane South PHN, Brisbane, Australia.
Luke ConnellyCentre for the Business and Economics of Health, University of Queensland, Brisbane, Queensland, Australia.
Jennifer A WhittySchool of Pharmacy, University of Queensland, Brisbane, Queensland, Australia.
Nancy SturmanSchool of Pharmacy, University of Queensland, Brisbane, Queensland, Australia.
Sue KirsaDepartment of Pharmacy, Monash Health, Clayton, Victoria, Australia.
Caroline NicholsonMater Misericordiae Health Services Brisbane Ltd, South Brisbane, Queensland, Australia.
Grant RussellSchool of Primary Health Care, Monash University, Notting Hill, Victoria, Australia.
Carl KirkpatrickCentre for Medicine Use and Safety, Monash University Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, Victoria, Australia.
Neil CottrellSchool of Pharmacy, University of Queensland, Brisbane, Queensland, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA model of general practitioner (GP) and pharmacist collaboration in primary care may be an effective strategy to reduce medication-related problems and provide better support to patients after discharge. The aim of this study is to investigate whether a model of structured pharmacist and GP care reduces hospital readmissions in high-risk patients. METHODS AND ANALYSIS: This protocol details a stepped-wedge, cluster-randomised trial that will recruit participants over 9 months with a 12-month follow-up. There will be 14 clusters each representing a different general practice medical centre. A total of 2240 participants will be recruited from hospital who attend an enrolled medical centre, take five or more long-term medicines or whose reason for admission was related to heart failure or chronic obstructive pulmonary disease.The intervention is a multifaceted service, involving a pharmacist integrated into a medical centre to assist patients after hospitalisation. Participants will meet with the practice pharmacist and their GP after discharge to review and reconcile their medicines and discuss changes made in hospital. The pharmacist will follow-up with the participant and liaise with other health professionals involved in the participant's care. The control will be usual care, which usually involves a patient self-organising a visit to their GP after hospital discharge.The primary outcome is the rate of unplanned, all-cause hospital readmissions over 12 months, which will be analysed using a mixed effects Poisson regression model with a random effect for cluster and a fixed effect to account for any temporal trend. A cost analysis will be undertaken to compare the healthcare costs associated with the intervention to those of usual care. ETHICS AND DISSEMINATION: The study has received ethical approval (HREC/16/QRBW/410). The study findings will be disseminated through peer-reviewed publications, conferences and reports to key stakeholders. TRIAL REGISTRATION NUMBER: ACTRN12616001627448.

Indexed as

General PractitionersPatient ReadmissionPharmacistsHealth Care CostsHeart FailureHumansMedication ReconciliationPrimary Health CareProfessional CorporationsPulmonary Disease, Chronic ObstructiveQuality of LifeResearch Designcollaborationmedicationpharmacistprimary careReadmissionstepped-wedge cluster design

Identifiers

PMID28408545
PMCPMC5719661

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.