Potentially Inappropriate Prescription Associated to Multimorbidity

Study Overview
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Brief Summary
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A prospective multicenter cohort study in 5 hospitals in Spain will be initiated in 2016. Objectives: To estimate and describe patterns of multimorbidity and polypharmacy in patients over 64 admitted for a chronic disease exacerbation. To analyze the potentially inappropriate prescribing (PPI) drugs according to STOPP / START (SS) criteria. To evaluate the relationship between multimorbidity and PPI and adverse medication (RAM) preventable reaction. The cohort will include 800 patients >64 years admitted in internal medicine and / or geriatric department of 5 hospitals of the National Health Service. Application of the SS criteria (released in 2015) on admission and at discharge, and collection of demographic and clinical variables including comorbidities, baseline chronic medication, geriatric syndromes, functional capacity and RAM. Descriptive analysis and bivariate parametric or nonparametric tests will be applied to analyze relationship between morbidity, polypharmacy, SS criteria and RAM. Intraobserver agreement will be assessed for SS criteria. Multiple regression techniques will be applied, where the dependent variable will be the PPI or the RAM.

Official Title
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Potentially Inappropriate Prescription Associated to Multimorbidity, Using the Explicit STOPP-START (Screening Tool of Older Persons' Potentially Inappropriate Prescriptions/Screening Tool to Alert Doctors to the Right Treatment) Criteria

Conditions
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Chronic Disease

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient admitted to the Internal Medicine or Geriatrics department Admitted to hospital because of an exacerbation of any previous chronic condition Exclusion Criteria: Terminal ill patients at admission Patients with lower forecast life than 1 year Patient admitted to the hospital only because an acute problem In patient home care

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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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: No intervention|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of patients with Potentially inappropriate medication, according to STOPP-START explicit criteria |  | At study entry | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of patients with Potentially inappropriate medication, according to STOPP-START explicit criteria |  | Through study completion, an average of 2 years | 
| Percentage of patients with polypharmacy | Polypharmacy=more than 5 chronic medications | At study entry | 
| Patients with any treatment-related adverse events (ADR), according to the Wills & Brown classification |  | Through study completion, an average of 2 years | 
| Percentage of different Patterns of multimorbidity in chronic patients, according to clusters or associations of different chronic conditions |  | At study entry | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multimorbidity, Polypharmacy, Appropriateness, STOPP, START