Rationalisation of Polypharmacy by the Geriatric Consultation Team

Study Overview
=================
Brief Summary
-----------------
Polypharmacy is a common problem in elderly, leading among others to increased adverse drug events. The aim of this pilot study was to evaluate whether a systematic medication evaluation by a geriatric consultation team using the RASP (Rationalisation of drugs on admission by an adjusted STOPP*-list in older patients) list could reduce inappropriate prescribing for elderly admitted patients, admitted to non-geriatric departments. (* = Screening Tool of Older Persons' potentially inappropriate Prescriptions)

Detailed Description
-----------------
Polypharmacy and (potentially) inappropriate prescribing is highly prevalent in the older population, associated with increase health care expenditures, morbidity and avoidable adverse events . The aim of this pilot study was to evaluate whether a systematic medication evaluation by a geriatric consultation team (GCT) using the RASP (Rationalisation of drugs on admission by an adjusted STOPP-list in older patients) list could reduce inappropriate prescribing for older admitted patients, admitted to non-geriatric departments. The GCT could offer the ideal format to deliver the intervention to a broad older hospitalised population.

Official Title
-----------------
Rationalisation of Polypharmacy by the Geriatric Consultation Team Using the RASP List: a Pilot Study

Conditions
-----------------
Iatrogenic Disease

Intervention / Treatment
-----------------
* Other: Medication review, based on but not limited to the RASP list


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Admitted to a non-geriatric ward 75 years or older Dutch speaking Consultation by the GCT Exclusion Criteria: End-of-life No drugs on admission

Ages Eligible for Study
-----------------
Minimum Age: 75 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: GCT<br>In a before phase, data on how the GCT operated (i.e. good clinical practice) was gathered. | |
| Active Comparator: GCT-RASP<br>Medication review, based on but not limited to the RASP list | Other: Medication review, based on but not limited to the RASP list<br>* Systematic approach: Medication reconciliation Applying the RASP list Expert review (not based on the RASP list) Multidisciplinary discussion<br>* Other names: Systematic medication review;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of medication-related recommendations by the geriatric consultation team. |  | The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of potentially inappropriate drugs at discharge, as identified by the RASP list. |  | The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days. | 
| Number of drugs at discharge, relative to the drugs on admission. |  | The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days. | 
| Acceptance rate of the GCT interventions by the treating physician. |  | Up to 72 hours after the GCT had given its recommendations. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
frailty, geriatric, elderly, polypharmacy