Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Prevention of Adverse Drug Events (ADEs) in Hospitalised Older Patients Using STOPP/START Criteria
Brief Summary: The next four decades will see a marked expansion of the elderly population in Ireland, in particular people aged over 80 yrs. Persons aged over 80 are the highest consumers of prescription medicines in Ireland and have the highest prevalence rates of major polypharmacy. Polypharmacy is intimately linked with serious adverse drug events (ADEs) and consequent major morbidity and mortality. Epidemiological data from the United States indicate that ADEs is the fifth most common cause of death nationally. Experts suggest that effective evidence based interventions can be applied to this major public health problem.

Recent research data indicate a cause-and-effect relationship between inappropriate prescription medicines and serious ADEs in older people in hospital. To date, Beers' criteria have been the dominant set of criteria for defining potentially inappropriate medicines (PIMs) in late life. Research data collected by this group show that the recently validated STOPP/START criteria (Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert doctors to Right Treatment) identify ADEs that are causal or contributory to acute hospital admission in older people 2.7 times more frequently than Beers' criteria. Based on these findings, our hypothesis is that STOPP/START criteria have the potential to be used as a regular intervention for the purpose of ADE prevention in older people. A recent single centre randomised control trial (RCT) undertaken at Cork University Hospital showed that prospective application of STOPP/START criteria led to a highly significant improvement in medication appropriateness in older hospitalised patients compared with standard inpatient pharmaceutical care. Significantly, the improvement in medication appropriateness was maintained to the end of the study follow-up i.e. 6 months post-discharge. However, the ability of STOPP/START criteria to significantly reduce ADEs in a prospective RCT has yet to be demonstrated.


Options:
A: Arm Label: Pharmaceutical care program; Type: EXPERIMENTAL; Interventions: Other: Pharmaceutical Care Program | Arm Label: Standard Care; Type: OTHER; Interventions: Other: Standard Care | Intervention Type: OTHER; Name: Pharmaceutical Care Program; Assigned to Arm(s): Pharmaceutical care program | Intervention Type: OTHER; Name: Standard Care; Assigned to Arm(s): Standard Care
B: Arm Label: Application of STOPP/START criteria; Type: ACTIVE_COMPARATOR; Interventions: Other: Application of STOPP/START criteria | Arm Label: Control; Type: NO_INTERVENTION; Interventions: Other: Normal pharmaceutical care | Intervention Type: OTHER; Name: Application of STOPP/START criteria; Assigned to Arm(s): Application of STOPP/START criteria | Intervention Type: OTHER; Name: Normal pharmaceutical care; Assigned to Arm(s): Control
C: Arm Label: usual care; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: basic intervention; Type: SHAM_COMPARATOR; Interventions: Other: basic intervention | Arm Label: extended intervention; Type: SHAM_COMPARATOR; Interventions: Other: extended intervention | Intervention Type: OTHER; Name: basic intervention; Assigned to Arm(s): basic intervention | Intervention Type: OTHER; Name: extended intervention; Assigned to Arm(s): extended intervention
D: Arm Label: control; Type: ACTIVE_COMPARATOR; Interventions: Other: Usual care for hospital discharge | Arm Label: intervention; Type: ACTIVE_COMPARATOR; Interventions: Other: Medication Information Transfer Intervention | Intervention Type: OTHER; Name: Medication Information Transfer Intervention; Assigned to Arm(s): intervention | Intervention Type: OTHER; Name: Usual care for hospital discharge; Assigned to Arm(s): control

Answer: B