PLoS ONE (Jan 2024)

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

  • Bruno Micael Zanforlini,
  • Sara Sambo,
  • Maria Devita,
  • Andrea Cignarella,
  • Federico Vezzali,
  • Silvia Sturani,
  • Andrea Grandieri,
  • Marianna Noale,
  • Paola Siviero,
  • Federica Limongi,
  • Stefano Volpato,
  • Giuseppe Sergi,
  • Caterina Trevisan,
  • APPROACH working group

DOI
https://doi.org/10.1371/journal.pone.0297238
Journal volume & issue
Vol. 19, no. 4
p. e0297238

Abstract

Read online

IntroductionPoor 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.MethodsData 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 registrationRegistration: NCT05719870 (clinicaltrial.gov). https://classic.clinicaltrials.gov/ct2/show/NCT05719870.