CLEAN-Meds: Carefully seLected and Easily Accessible at No Charge Medications
Study Details
Study Description
Brief Summary
This trial evaluates the effect of providing primary care patients with free and convenient access to a set of essential medicines. Half of the participants will receive free and convenient access to these essential medicines, while the other half will have usual access to medicines.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Medication adherence is one important determinant of health outcomes. Approximately one half of treatments for chronic disease are not taken as directed. Cost is one of several important causes of poor adherence and it is particularly important for vulnerable people.
The size of many formularies makes it difficult for clinicians to know the safest and most effective medications to prescribe. This may partially explain poor medication selection. Short lists of essential medications have improved the the quality of prescribing.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Free and convenient medicine access Free access to a list of essential medicines. Medicines are either mailed to the patient or dispensed at the point of care. |
Other: Free and convenient medicine access
|
| No Intervention: Usual medicine access Usual access to medicines. |
Outcome Measures
Primary Outcome Measures
- Appropriate medicine adherence [During entire study period (24 months)]
The percentage of patients taking medicines that are both (1) appropriate based on explicit criteria and (2) taken as prescribed or adhered to for 80 % of doses
Secondary Outcome Measures
- Percentage (%) of prescriptions that are appropriate. [During entire study period (24 months)]
- Percentage (%) of prescriptions that are adhered to. [During entire study period (24 months)]
- Hemoglobin A1c levels in patients with diabetes (adjusted for baseline) [Assessed between months 21 and 24 inclusive]
- Blood pressure in hypertensive patients (adjusted for baseline) [Assessed between months 21 and 24 inclusive]
- LDL cholesterol levels in patients taking a statin (adjusted for baseline [Assessed between months 21 and 24 inclusive]
- Healthcare costs including medication costs [During entire study period (24 months)]
Other Outcome Measures
- Count of healthcare encounters [During entire study period (24 months)]
Includes ambulatory visits, emergency department visits, hospital admission, investigations and other healthcare utilization.
Eligibility Criteria
Criteria
Inclusion Criteria:
- Cost related medicine non-adherence during last 12 months
Exclusion Criteria:
-
Family member living at same address of patient who is already enrolled in this trial
-
Patient joined practice during last 6 months
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Municipality of Assiginack Family Health Team | Assiginack | Ontario | Canada | P0P 1N0 |
| 2 | Huron Shores Family Health Team | Blind River | Ontario | Canada | P0R 1B0 |
| 3 | St Michael's Hospital Academic Family Health Team | Toronto | Ontario | Canada | M5B 1W8 |
Sponsors and Collaborators
- Unity Health Toronto
- The Ontario Spor Support Unit
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 15-114