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Therapeutic Conflicts and Multimorbidity

Completed
Conditions
Gastrointestinal Hemorrhage
Multimorbidity
Diabetes Complications
Interventions
Other: drug-drug or drug-disease interaction
Registration Number
NCT02928939
Lead Sponsor
University of Zurich
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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1101
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)
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Exclusion Criteria
  • If potential participants have a statement in the electronic medical record or elsewhere to refuse study participation, this represents exclusion criteria.
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Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Multimorbid patientsdrug-drug or drug-disease interaction-
Primary Outcome Measures
NameTimeMethod
Patients with gastrointestinal bleeding and anticoagulants or antiplatelet drugs5 years

Do anticoagulants or antiplatelet drugs increase the risk of repeated bleeding in patients with gastrointestinal bleeding?

Patients with diabetes mellitus and systemic corticosteroids5 years

Do systemic corticosteroids increase the risk of exacerbation in patients with diabetes mellitus?

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

University Hospital Zurich

🇨🇭

Zurich, Switzerland

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