Impact of Medications Review on Potentially Inappropriate Medications and Clinical Outcomes Among Hospitalized Older Adults

Not Applicable

Active, not recruiting

• Conditions: Potentially Inappropriate Medications; Aged; Deprescriptions; Inappropriate Prescribing; Polypharmacy
• Interventions: Other: MALPIP criteria

• Registration Number: NCT05875623
• Lead Sponsor: Monash University

Brief Summary

The goal of this randomized controlled trial is to assess the effectiveness of a pharmacist-led medication review using the locally developed Malaysian Potentially Inappropriate Prescribing Screening tool in Older Adults (MALPIP), an explicit criteria in hospitalized older adults. The main questions it aims to answer are:

1. The effectiveness of the intervention in reducing the number of PIMs and chronic medications after discharge

2. The impact of the intervention on quality of life, falls events, emergency department visits, readmissions and survivals

Researchers will compare the control group to see if there is corresponding changes to the outcomes specified above.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-05-16
• Study First Submitted QC: 2023-05-16
• Study First Posted: 2023-05-25
• Study Start: 2023-07-06
• Status Verified: 2024-11
• Last Update Submitted: 2025-05-05
• Last Update Posted: 2025-05-08
• Primary Completion: 2025-08-28
• Study Completion: 2025-12-30

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 500

Inclusion Criteria

• Patients aged 60 years and above
• Taking more than five regular drugs
• Having at least one chronic medical condition
• Ability to understand and speak Malay, English, or Mandarin language

Exclusion Criteria

• Admitted for end-of-life care
• Diagnosed with terminal illness
• Diagnosed with active cancer
• Participated in another drug trial
• Refused or unable to give consent
• Visited the Emergency Department without admission to ward
• Readmitted and have been previously enrolled in the trial

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention	MALPIP criteria	In the intervention group, the clinical pharmacist will apply the MALPIP criteria on all the admission and discharge medications. The pharmacists can access the full MALPIP list at https://sites.google.com/moh.gov.my/malpip/home. The intervention will consist of 4 steps: i) pharmacist review using MALPIP criteria to detect PIM, ii) discussion with doctors for deprescribing decision iii) discussion with patients and documentation of shared decision iv) follow up patients at 6, 12, and 18 months. Pharmacists will perform the reviewing and checking by themselves and discuss the suggestions with doctors during daily medical ward rounds. The attending doctors will decide whether to deprescribe based-on pharmacists suggestions. Then, the pharmacists will discuss the deprescribing proposal with the patients and record the decision.

Primary Outcome Measures

Name	Time	Method
Number of potentially inappropriate medications	Admission up to 18 months
Number of chronic medications	Admission up to 18 months

Trial Locations

Locations (1)

Shaun Lee; 🇲🇾 Subang Jaya, Selangor, Malaysia