Evidence map›Paper›PMID 32366308›Full record

Trial reportBMC health services research2020

A stepped wedge trial of efficacy and scalability of a virtual clinical pharmacy service (VCPS) in rural and remote NSW health facilities.

Julaine Allan, Shannon Nott, Brett Chambers, Ged Hawthorn, Alice Munro, Chris Doran, Chris Oldmeadow, Clare Coleman, Teesta Saksena

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
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, 11 citations in OpenAlex.

  1. Trial
  2. Article
  3. Virtual clinical pharmacy services: A model of care to improve medication safety in rural and remote Australian health services.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2022
    Article
  4. Article
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

9 authors at 4 institutions in 1 country.

Julaine AllanSchool of Health and Society, University of Wollongong, Wollongong, Australia. julaineallan@gmail.com.
Shannon NottWestern NSW Local Health District, Dubbo, Australia.
Brett ChambersWestern NSW Local Health District, Dubbo, Australia.
Ged HawthornWestern NSW Local Health District, Dubbo, Australia.
Alice MunroWestern NSW Local Health District, Dubbo, Australia.
Chris DoranCentral Queensland University, Brisbane, Australia.
Chris OldmeadowHunter Medical Research Institute, Newcastle, Australia.
Clare ColemanWestern NSW Local Health District, Dubbo, Australia.
Teesta SaksenaWestern NSW Local Health District, Dubbo, Australia.
Western NSW Local Health District · AUCentral Queensland University · AUHunter Medical Research Institute · AUUniversity of Wollongong · AU

Funding

NSW Ministry of Health FE7801
6 · The paper itself

Abstract

backgroundMedication errors are a leading cause of mortality and morbidity. Clinical pharmacy services provided in hospital can reduce medication errors and medication related harm. However, few rural or remote hospitals in Australia have a clinical pharmacy service. This study will evaluate a virtual clinical pharmacy service (VCPS) provided via telehealth to eight rural and remote hospitals in NSW, Australia.

methodsA stepped wedge cluster randomised trial design will use routinely collected data from patients' electronic medical records (n = 2080) to evaluate the VCPS at eight facilities. The sequence of steps is randomised, allowing for control of potential confounding temporal trends. Primary outcomes are number of medication reconciliations completed on admission and discharge. Secondary outcomes are length of stay, falls and 28 day readmissions. A cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) will be conducted. The CEA will answer the question of whether the VCPS is more cost-effective compared to treatment as usual; the CBA will consider the rate of return on investing in the VCPS. A patient experience measure (n = 500) and medication adherence questionnaire (n = 100 pre and post) will also be used to identify patient responses to the virtual service. Focus groups will investigate implementation from hospital staff perspectives at each site. Analyses of routine data will comprise generalised linear mixed models. Descriptive statistical analysis will summarise patient experience responses. Differences in medication adherence will be compared using linear regression models. Thematic analysis of focus groups will identify barriers and facilitators to VCPS implementation. DISCUSSION: We aim to demonstrate the effectiveness of virtual pharmacy interventions for rural populations, and inform best practice for using virtual healthcare to improve access to pharmacy services. It is widely recognised that clinical pharmacists are best placed to reduce medication errors. However, pharmacy services are limited in rural and remote hospitals. This project will provide evidence about ways in which the benefits of hospital pharmacists can be maximised utilising telehealth technology. If successful, this project can provide a model for pharmacy delivery in rural and remote locations.

trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) -ACTRN12619001757101 Prospectively registered on 11 December 2019. Record available from: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378878&isReview=true.

Indexed as

Pharmacy Service, HospitalRural Health ServicesTelemedicineAdultCost-Benefit AnalysisFemaleFocus GroupsHealth Services ResearchHumansMaleMedication ErrorsNew South WalesClinical pharmacyHospitalPatient experienceRemoteRuralStepped wedgeTelehealthVirtual healthcare

Identifiers

PMID32366308
PMCPMC7197111
OpenAlexW3023656844

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.