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临床试验/NCT05327634
NCT05327634已完成不适用

Description of the Obstacles to Deprescribing Among French Patients Over 75 Years of Age Treated in the Geriatric Hospital Network

Hôpital NOVO4 个研究点 分布在 1 个国家目标入组 120 人开始时间: 2022年4月1日最近更新:
适应症

试验速览

阶段
不适用
状态
已完成
发起方
入组人数
120
试验地点
4
主要终点
Description of the obstacles to the withdrawal of medication in patients over 75 years of age in the geriatric sector

研究概览

简要总结

The aim of this study is to highlight action guidelines to encourage acceptance of deprescribing in people over 75 years of age: training, therapeutic education, post-prescription follow-up, specific patient pathways, specific consultations or even the integration of an advanced practice nurse in this process.

详细描述

For several years now, the proportion of senior citizens in our country has been rising steadily. There are now 6.4 million people over the age of 75 in France.

It is therefore important to take into account the needs and specificities of this part of the population. One of its particularities is polypathology. Indeed, from the age of 70 onwards, 93% of elderly subjects have at least 2 diseases and 85% have at least 3. This polypathology will lead to a large number of different prescribers with an increased risk of having more than 5 molecules in their personal treatment. This is known as polypharmacy.

In the elderly, polypharmacy is harmful. It increases the risk of adverse effects and drug interactions. In France, 20% of patients over 75 years old and 25% of those over 85 years old consult the emergency room because of adverse drug reactions.

The literature shows that we can act on these adverse events by "deprescribing". De-prescribing is defined as intentionally stopping the prescription of an unnecessary or potentially dangerous drug for a patient.

The expected benefit for the patient is to reduce the iatrogenic risks induced by treatments that would no longer be useful for him/her or that have a negative benefit/risk balance. To achieve this objective, the patient must understand this risk, understand the benefit he or she can derive from it and be an actor in this process.

研究设计

研究类型
Observational
观察模型
Cohort
时间视角
Prospective

入排标准

年龄范围
75 Years 至 —(Older Adult)
性别
All
接受健康志愿者

入选标准

  • Patients aged 75 years and over
  • Hospitalized in geriatric short-stay or geriatric rehabilitation units
  • Patients who did not object to participation in the study

排除标准

  • Patient refusal
  • Patients not able to understand and fill in the questionnaire: Cognitive disorders, Confusion, Unstable clinical state, Sensory disorders, not speaking French.
  • Patient under protective supervision (guardianship or curatorship)

结局指标

主要结局

Description of the obstacles to the withdrawal of medication in patients over 75 years of age in the geriatric sector

时间窗: Baseline

The main evaluation criterion will be measured using the self-questionnaire: a revised form of the 5-point Likert-type "Revised Patients' Attitude Toward Deprescribing" (rPATD), validated in French. Discouragement will be assessed on the basis of the overall score of questions 1 to 20 of the self-questionnaire, with regard to questions 21 and 22.

次要结局

  • Assessment of the relationship between patient burden and acceptance (or refusal) of deprescribing.(Baseline)
  • Assessment of the relationship between the benefit of the treatment experienced by the patient and the acceptance (or refusal) of the deprescribing(Baseline)
  • Assessment of the relationship between concern about possible negative effects of discontinuing treatment and acceptance (or refusal) of deprescribing(Baseline)
  • Assessment of the relationship between certain families of treatments and acceptance (or refusal) of deprescribing(Baseline)
  • Assessment of the relationship between the patient's good knowledge of their treatments and acceptance (or refusal) of the deprescribing.(Baseline)

研究者

发起方
Hôpital NOVO
申办方类型
Other
责任方
Sponsor

研究点 (4)

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