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Pharmacy Integrated Transitions (PIT) trial: a protocol for a pragmatic cluster-randomised crossover trial
Mariam N Hantouli1, Sarah E Monsell2, Giana H Davidson3
1University of Washington Department of Surgery, Seattle, Washington, USA hantouli@uw.edu.
BMJ Open
|December 31, 2024
Summary
The Pharmacy Integrated Transitions (PIT) programme improves medication safety during hospital to skilled nursing facility transitions. This intervention reduces medication errors and enhances patient care coordination.
Area of Science:
- Healthcare delivery science
- Patient safety research
- Medication management systems
Background:
- Hospital to skilled nursing facility (SNF) transitions are complex, leading to significant costs and adverse events.
- Medication errors affect approximately 70% of patients during care transitions, causing distress and readmissions.
- Existing protocols often fail to ensure effective medication management and communication between hospital and SNF teams.
Purpose of the Study:
- To evaluate the effectiveness of the Pharmacy Integrated Transitions (PIT) programme in improving patient care transitions.
- To compare the PIT programme's impact on medication safety and communication against usual care.
- To characterize stakeholder perspectives on the PIT programme's implementation, effectiveness, and sustainability.
Main Methods:
- A parallel cluster-randomised controlled crossover trial design involving 4 hospitals and 14 SNFs in Washington State.
- SNFs were stratified by patient volume and randomly assigned to either the PIT programme or usual care.
- The primary outcome was medication-related problems within 30 days post-discharge, with secondary outcomes including adverse events and readmissions. A mixed-methods evaluation assessed stakeholder perspectives.
Main Results:
- The PIT trial is ongoing; primary and secondary outcome data are not yet available.
- Stakeholder perspectives on implementation fidelity, effectiveness, and support needs are being collected.
- The study design allows for rigorous evaluation of the PIT programme's impact on care transitions.
Conclusions:
- The Pharmacy Integrated Transitions (PIT) programme has the potential to enhance medication safety and communication during care transitions.
- Further results are anticipated to inform best practices for managing patients moving from hospitals to SNFs.
- The study will provide valuable insights into the implementation and sustainment of interventions aimed at improving healthcare transitions.
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