Multidisciplinary Program "Optimization of Drug Prescription" : Impact on the Quality of Drug Prescription in Hospitalized Elderly Patients

Completed

• Conditions: Potentially Inappropriate Medications
• Interventions: Other: " Optimisation de la Prescription MEDicamenteuse " ("Optimization of drug prescribing")

• Registration Number: NCT01947270
• Lead Sponsor: Hospices Civils de Lyon

Brief Summary

Drug prescription is a fundamental component of care for the elderly. Even if drugs are a chance for the older patient, because of changes in pharmacological, pharmacokinetic and pharmacodynamic parameters related with age and acute/or chronic pathologies, the risks associated with drug prescription, particularly those associated with potentially inappropriate medication (PIM), are increased in the elderly.

We suppose that many of hospitalized elderly have at least one prescribed medication without valid indication. Conversely, many diseases are currently undertreated in elderly patients: e.g. medicines used to treat heart failure and osteoporosis are underused in 20 to 70% of patients. Moreover, PMI prescription is associated with an increased of morbidity, mortality, risk of drug-related adverse events, utilization of health care system, care costs and impairment of quality of life. Thus, optimization of drug prescription is a major concern for improvement of the quality and safety of care in elderly.

The investigators' hypothesis is that a multidisciplinary program entitled "Optimisation de la Prescription MEDicamenteuse" ("Optimization of drug prescribing") focused on drug prescription optimization including a physician training to the specificity of the drug prescription in the elderly and a checklist allowing an adapted and standardized pharmaceutical analysis is effective in reducing PIM in elderly patients hospitalized in short-term medical and geriatric care departments.

Detailed Description

Not available

Study Timeline

• Study Start: 2013-01
• Study First Submitted: 2013-07-26
• Study First Submitted QC: 2013-09-19
• Study First Posted: 2013-09-20
• Primary Completion: 2017-06
• Study Completion: 2017-06
• Status Verified: 2017-09
• Last Update Submitted: 2017-09-27
• Last Update Posted: 2017-09-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 3055

Inclusion Criteria

• Male or female subject aged over 75 years hospitalized in one of the participating department
• Patient agreed to participate

Exclusion Criteria

• Patient with a predictive length of stay equal or less than 48 hours
• Patients admitted in terminal illness

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Intervention group	" Optimisation de la Prescription MEDicamenteuse " ("Optimization of drug prescribing")	Patients of this group are hospitalized in a time frame where the multidisciplinary intervention program is implemented in the medical department.

Primary Outcome Measures

Name	Time	Method
Proportion of potentially inappropriate medications (PIM) prescribed in discharge of hospitalized patients from 75 years old.	at discharge (average 3 weeks)	Proportion of prescribed PIM will be expressed as the ratio of PIM to the total number of medication in discharge prescription sheet.; PIM will be identified by 2 experts (1 doctor and 1 pharmacist) based on criteria from the lists STOPP/START and Laroche.

Secondary Outcome Measures

Name	Time	Method
Total number of drugs prescribed per discharge prescription sheet	at discharge (average 3 weeks)
Number of emergency admission within 12 months following hospitalization	12 months after inclusion
Number of rehospitalization within 12 months following discharge	12 months after inclusion
Mortality within 12 months after hospitalization	12 months after inclusion

Trial Locations

Locations (1)

Hospices Civils de Lyon - Hôpital Edouard Herriot; 🇫🇷 Lyon, France