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Will an individualised service improve medicine administration to adults with dysphagia - a pilot study?
ISRCTN ISRCTN77708631
ClinicalTrials.gov identifier
Public title Will an individualised service improve medicine administration to adults with dysphagia - a pilot study?
Scientific title A non-randomised process of care case-controlled study of an individualised service to improve medicine administration to adults with dysphagia
Acronym DYS-MED
Serial number at source 7288
Study hypothesis To estimate:
1. The likely effect of a dedicated pharmacist's introduction of individualised medicine administration guides (I-MAGs) on nurses' clinical practice and medicine administration error (MAE) rate (primary outcome measure)
2. The likely effect of the introduction of I-MAGs on patients' health-related quality-of-life, post-discharge adherence and hospitalisation (secondary outcome measures)
3. Whether randomisation for such a trial should occur at ward or hospital level
4. The most efficient method of patient recruitment, the likely 'drop out' rate, the best outcome measures, and the feasibility of a full cost-effectiveness analysis
Lay summary
Ethics approval Essex 2 Research Ethics Committee (REC) approved on the 16th January 2009 (ref: 08/H0302/153)
Study design Non-randomised interventional and observational process of care case-controlled study
Countries of recruitment United Kingdom
Disease/condition/study domain Topic: Generic Health Relevance and Cross Cutting Themes; Subtopic: Generic Health Relevance (all Subtopics); Disease: Age and ageing
Participants - inclusion criteria 1. Patients with dysphagia
2. Based in three Care of the Elderly wards and one Stroke unit at the Norfolk and Norwich University Hospital
3. Consent to take part
4. Taking medication
5. Registered nurses working on the same four wards who consent to take part
Participants - exclusion criteria Unable to communicate in English
Anticipated start date 01/07/2010
Anticipated end date 01/11/2010
Status of trial Completed
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants Planned Sample Size: 360; UK Sample Size: 360
Interventions Whilst an inpatient the intervention patient group will receive their medicines as prescribed by the doctors caring for them in the normal way. A pharmacist, employed for the purposes of the study, will develop an individualised medicine administration guide for each patient which will be used by the nurses administering medicines to those patients to guide appropriate preparation and administration. Prior to discharge the pharmacist employed for the project will adapt the individualised medicine administration guide to reflect the medcines the patient is to be discharged on, and will teach the patient how to use it. Copies will also be sent to the patient's GP and local community pharmacist.

The control group will not have these individualised medicine administration guides.

Both groups will be followed up for six months after discharge from hospital and will be asked to complete four questionnaires on discharge, six weeks and six months post discharge.

The primary outcome measure for the study is a decrease in medicine administration errors by the nurses administering medicines to patients in the intervention and control groups. The nurses will be given a questionnaire about aspect of medicine administration at the begining of the study and 16 will be observed administering medicines to patients on the four wards involed, i.e. the two intervention and two contiol wards. After six months the questionnaire will be re-administered and 16 medicine adminisration rounds will be observed.
Primary outcome measure(s) Whether the introduction of individualised medicine administration guides reduce the number of medication errors.
Secondary outcome measure(s) The likely effect of the introduction of individualised medicine administration guides on health related quality of life measures, patient satisfaction with information and pharmaceutical care and medicine adherence. These will be measured at patient discharge, six weeks and six months after discharge.
Sources of funding National Institute for Health Research (NIHR) (UK) - Research for Patient Benefit (RfPB) Programme
Trial website
Publications
Contact name Mrs  Jenny  Kelly
  Address School of Pharmacy
University of East Anglia
  City/town Norwich
  Zip/Postcode NR4 7TJ
  Country United Kingdom
Sponsor University of East Anglia (UK)
  Address School of Medicine
Earlham Road
  City/town Norwich
  Zip/Postcode NR4 7TJ
  Country United Kingdom
  Email research.acad@uea.ac.uk
  Sponsor website: http://www.uea.ac.uk/
Date applied 29/04/2010
Last edited 30/04/2010
Date ISRCTN assigned 29/04/2010
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