Therapeutic Conflicts in Hospitalized Patients: Retrospective Analyses of Patients With GI Bleeding or Exacerbated Diabetes and Impact of Multimorbidity.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Zurich
- Enrollment
- 1,101
- Locations
- 1
- Primary Endpoint
- Patients with gastrointestinal bleeding and anticoagulants or antiplatelet drugs
Study Overview
Brief Summary
Clinical practice guidelines do not take into account multimorbidity and various potential therapeutic conflicts. Identifying and quantifying therapeutic conflicts is crucial in multimorbid patients having more than two acute or chronic diseases. Guidance should be available for frequent encountered situations, e.g. gastrointestinal bleeding or exacerbation of diabetes mellitus.
Detailed Description
The study investigates multimorbidity in view of the occurrence of two different therapeutic conflicts or dilemma situations, respectively. The first concerns patients with diagnosis of gastrointestinal bleeding and prescription of anticoagulants or/and antiplatelet drugs (e.g., warfarin, clopidogrel and acetylsalicylic acid) as a risk factor for bleeding events. The second concerns patients with diagnosis of exacerbated diabetes mellitus and prescription of corticosteroids as a risk factor for worsening of blood glucose.
Study Design
- Study Type
- Observational
- Observational Model
- Other
- Time Perspective
- Retrospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Inpatients at the University Hospital Zurich, USZ
- •Male and female patients, aged 18 years or older
- •Fulfilling the criteria for Use Case A or B (i.e. patients with gastrointestinal bleeding and anticoagulants or antiplatelet drugs, Use Case A or patients with diabetes mellitus and/or systemic corticosteroids, Use Case B)
Exclusion Criteria
- •If potential participants have a statement in the electronic medical record or elsewhere to refuse study participation, this represents exclusion criteria.
Outcomes
Primary Outcomes
Patients with gastrointestinal bleeding and anticoagulants or antiplatelet drugs
Time Frame: 5 years
Do anticoagulants or antiplatelet drugs increase the risk of repeated bleeding in patients with gastrointestinal bleeding?
Patients with diabetes mellitus and systemic corticosteroids
Time Frame: 5 years
Do systemic corticosteroids increase the risk of exacerbation in patients with diabetes mellitus?
Secondary Outcomes
No secondary outcomes reported