A multidisciplinary approach to improve adherence to medical recommendations in older adults at hospital discharge: The APPROACH study protocol

PLoS One. 2024 Apr 30;19(4):e0297238. doi: 10.1371/journal.pone.0297238. eCollection 2024.

Abstract

Introduction: Poor comprehension and medication adherence are common in older people, especially after hospitalizations, in case of changes or prescriptions of new therapeutic regimes. This randomized controlled trial aims to evaluate the effectiveness of an integrated approach in improving older individuals' adherence to medical recommendations after hospital discharge.

Methods: Data from an expected sample of 360 older inpatients (and their caregivers) will be collected. Medical recommendations' understanding will be tested before and after the routine explanation received by in-charge physicians. Participants will be randomized in the control (usual care) and intervention group. The intervention consists of educational training by a multidisciplinary team (occupational therapist, dietician, and physician, in consultation with a pharmacologist) at hospital discharge and, after hospital discharge, receiving a phone recall checking for therapy adherence and having the possibility to contact the study team for potential related concerns. After 7 days, medication adherence will be assessed through structured phone interviews comparing ongoing and prescribed medications and by administering the 4-item validated Morisky, Green, Levine scale and the Medication adherence report scale (MARS-5). At 30 and 90 days from discharge, data on medication adherence, falls, rehospitalizations, and vital status will be collected through phone interviews and hospital records.

Trial registration: Registration: NCT05719870 (clinicaltrial.gov). https://classic.clinicaltrials.gov/ct2/show/NCT05719870.

Publication types

  • Research Support, Non-U.S. Gov't
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Medication Adherence*
  • Patient Care Team
  • Patient Discharge*

Associated data

  • ClinicalTrials.gov/NCT05719870

Grants and funding

We confirm that the project is supported by a Pfizer Quality Improvement grant (n. 53789559). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.