Impact of Multidisciplinary Review of Drug Prescriptions on Patient Safety in a Residence for Dependent Elderly

Study Overview
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Brief Summary
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The main objective of the study is to show that the multidisciplinary review of drug prescriptions changes the adverse drug event (ADE) geriatric risk score (according to Trivalle and Ducimetière 2013) for patients living in the Nîmes University Hospital Residence for Dependent Elderly.

Detailed Description
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The secondary objectives of this study are to assess and compare the following criteria before and after multidisciplinary review of drug prescriptions for patients in the Nîmes University Hospital Residence for Dependent Elderly: A. the number of patients with at least one potentially inappropriate drug prescribed B. the number of hospitalizations C. death rate D. the number of falls per patient and the rate of fallers E. qualitative criteria describing the drug review F. associated care costs

Official Title
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Impact of Multidisciplinary Review of Drug Prescriptions on Patient Safety in a Residence for Dependent Elderly

Conditions
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Geriatrics, Residence for Dependent Elderly, Health Services for the Aged

Intervention / Treatment
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* Other: Before-after study


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patient (or his/her legal representative) must have given his/her informed and signed consent The patient must be insured or beneficiary of a health insurance plan The patient is available for 6 months of follow-up The patient has resided at the Nîmes University Hospital Residence for Dependent Elderly for at least the past 6 months Exclusion Criteria: The patient is participating in another study The patient is in an exclusion period determined by a previous study The patient is under judicial protection The patient (or his/her legal representative) refuses to sign the consent It is impossible to correctly inform the patient (or his/her legal representative) The patient has resided at the Nîmes University Hospital Residence for Dependent Elderly for less than 6 months

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: The study population<br>See inclusion and exclusion criteria. Intervention: Before-after study | Other: Before-after study<br>* The before-after study is composed of a first observational phase followed by a proactive phase, and then finally by a second observational phase. The first observational phase corresponds to retrospective data-collecting for the information necessary for calculating the baseline ADE geriatric risk score. The proactive phase corresponds to a multidisciplinary review of drug prescriptions (especially long-term drugs) for all included patients in the residence. During the second observational phase, the same data as in the first observational phase will be collected a second time.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adverse Drug Events Geriatric Risk Score | according to Trivalle and Ducimetière 2013 | change from Baseline to 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of patients taking at least 1 potentially inappropriate drug according to Laroche criteria | Laroche et al 2007. | During the proactive phase. Day 0. | 
| Number of hospitalizations in the public sector (higher level care) |  | first observational phase (month -6 to day 0) | 
| Number of hospitalizations in the public sector (higher level care) |  | second observational phase (day 0 to month 6) | 
| Days of hospitalization in the public sector (higher level care) |  | first observational phase (month -6 to day 0) | 
| Days of hospitalization in the public sector (higher level care) |  | second observational phase (day 0 to month 6) | 
| Mortality |  | first observational phase (month -6 to day 0) | 
| Mortality |  | second observational phase (day 0 to month 6) | 
| The number of falls per patient |  | first observational phase (month -6 to day 0) | 
| The number of falls per patient |  | second observational phase (day 0 to month 6) | 
| The percentage of patients who fell |  | first observational phase (month -6 to day 0) | 
| The percentage of patients who fell |  | second observational phase (day 0 to month 6) | 
| The Anatomical Therapeutic Chemical classification for each revised drug |  | during the proactive phase (day 0) | 
| The type of errors detected during drug review | Contra-indication, dosing, route, etc | during the proactive phase (day 0) | 
| The type of modification suggested during drug review | discontinuation, addition, substitution... | during the proactive phase (day 0) | 
| The acceptation rate for modifications suggested during drug review |  | during the proactive phase (day 0) | 
| Associated care costs (€) |  | first observational phase (month -6 to day 0) | 
| Associated care costs (€) |  | second observational phase (day 0 to month 6) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multidisciplinary review of drug prescriptions, Adverse drug events geriatric risk score, Residence for dependent elderly