title: Effectiveness of pharmaceutical care at discharge in the emergency department: study protocol of a randomized controlled trial.
abstract: BACKGROUND
  Patient education on pharmacological therapy may increase medication adherence and decrease hospitalizations. Our aim is to evaluate the effectiveness of pharmaceutical care at emergency department discharge in patients with hypertension and/or diabetes.
  
  
  METHODS
  This is a randomized controlled trial. Participants will be recruited from a public emergency department at Restinga district in Porto Alegre, southern Brazil. A total of 380 patients will be randomly assigned into 2 groups at the moment of emergency department discharge after receiving medical orientations: an intervention group, consisting of a structured individual counseling session by a pharmacist in addition to written orientations, or a control group, consisting only of written information about the disease. Outcomes will be assessed in an ambulatory visit 2 months after the randomization. The primary outcome is the proportion of patients with high medication adherence assessed using the Morisky-Green Test and the Brief Medication Questionnaire. The secondary outcomes are reduction of blood pressure, glycated hemoglobin, fasting plasma glucose, quality of life and number of visits to the emergency department.
  
  
  CONCLUSIONS
  Pharmaceutical care interventions have shown to be feasible and effective in increasing medication adherence in both hospital outpatient and community pharmacy settings. However, there have been no previous assessments of the effectiveness of pharmacy care interventions initiated in patients discharged from emergency departments. Our hypothesis is that pharmaceutical counseling is also effective in this population.
  
  
  BACKGROUND
  ClinicalTrials.gov registration number: NCT01978925 (11 November 2013) and Brazilian Registry of Clinical Trials U1111-1149-8922 (5 November 2013).
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. regina.kuhmmer@hmv.org.br.|Graduate Program in Cardiology and Cardiovascular Science, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. regina.kuhmmer@hmv.org.br.
authors.forename: Regina
authors.initials: R
authors.lastname: Kuhmmer
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. karine.lima@hmv.org.br.|Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. karine.lima@hmv.org.br.
authors.forename: Karine Margarites
authors.initials: KM
authors.lastname: Lima
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. rodrigo.ribeiro@hmv.org.br.|Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. rodrigo.ribeiro@hmv.org.br.
authors.forename: Rodrigo Antonini
authors.initials: RA
authors.lastname: Ribeiro
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. luciano.hammes@hmv.org.br.
authors.forename: Luciano Serpa
authors.initials: LS
authors.lastname: Hammes
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. gisele.nader@hmv.org.br.|Department of Public Health, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. gisele.nader@hmv.org.br.
authors.forename: Gisele Alsina Nader
authors.initials: GA
authors.lastname: Bastos
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. maria.souza@hmv.org.br.|Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. maria.souza@hmv.org.br.
authors.forename: Maria Claudia Schardosim
authors.initials: MC
authors.lastname: Cotta de Souza
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. carisi.polanczyk@hmv.org.br.|Graduate Program in Cardiology and Cardiovascular Science, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. carisi.polanczyk@hmv.org.br.|Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. carisi.polanczyk@hmv.org.br.
authors.forename: Carisi Anne
authors.initials: CA
authors.lastname: Polanczyk
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. guilhermerollin@ibest.com.br.
authors.forename: Guilherme Alcides Flores
authors.initials: GA
authors.lastname: Soares Rollin
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. suhelen.caon@hmv.org.br.
authors.forename: Suhelen
authors.initials: S
authors.lastname: Caon
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. catiamoreiraguterres@gmail.com.
authors.forename: Cátia Moreira
authors.initials: CM
authors.lastname: Guterres
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. leniaraujoleite@yahoo.com.br.
authors.forename: Leni Everson
authors.initials: LE
authors.lastname: Araújo Leite
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. tatss.delabary@gmail.com.
authors.forename: Tássia Scholante
authors.initials: TS
authors.lastname: Delabary
authors.affiliation: Institute for Education and Research, Hospital Moinhos de Vento, Rua Ramiro Barcellos 910, Bloco D, Porto Alegre, RS, 90035-001, Brazil. maicon.falavigna@hmv.org.br.|Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. maicon.falavigna@hmv.org.br.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. maicon.falavigna@hmv.org.br.
authors.forename: Maicon
authors.initials: M
authors.lastname: Falavigna
mesh_terms: D002985:Clinical Protocols; D003627:Data Interpretation, Statistical; D004636:Emergency Service, Hospital; D006801:Humans; D055118:Medication Adherence; D010351:Patient Discharge; D010607:Pharmacy Service, Hospital; D018401:Sample Size