Benefit of a Collaborative Approach to Improve the Quality of Medicines Use in Elderly Inpatients

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the impact of a collaborative approach (geriatric care involving the collaboration with a clinical pharmacist) to optimize the prescription of medicines for elderly inpatients.

Detailed Description
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Widespread evidence reveals frequent inadequate use of medicines in elderly patients. This includes inappropriate prescribing (overuse, underuse, misuse) that can lead to adverse drug events and drug-related admissions to hospital. In addition, when a patient is transferred from acute care settings to ambulatory care settings, discrepancies in medicines used often occur and can be hazardous. Despite this, only limited data exist on the effectiveness of optimization strategies targeted at frail elderly inpatients. Comparison: elderly inpatients receiving geriatric evaluation and management (GEM) care versus elderly inpatients receiving pharmaceutical care in addition to GEM care.

Official Title
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Collaborative Approach to Improve the Quality of Medicines Use in Elderly Inpatients - Randomized Controlled Trial

Conditions
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Frail Elderly Inpatient

Intervention / Treatment
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* Behavioral: Pharmaceutical care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient admitted on the acute geriatric unit of the university teaching hospital Mont-Godinne, Belgium Exclusion Criteria: a terminal illness and life expectancy of less than 3 month expected length of stay of 2 days or less transfer from another unit where the patient had already been cared for by a GEM team refusal to participate inclusion during previous admission no time for the clinical pharmacist to compound the abstracted chart within 3 days of admission

Ages Eligible for Study
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Minimum Age: 70 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: Educational/Counseling/Training
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Pharmaceutical care|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Appropriateness of prescribing (using the Medication Appropriateness Index, the Beers criteria, and the ACOVE criteria of underuse) on admission, at discharge, and 3 months post-discharge |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Polymedication on admission, at discharge, and 1,3,12 months after discharge |  |  | 
| Mortality, readmission to hospital and visit to the emergency department 1,3,12 months after discharge |  |  | 
| Satisfaction with information received on medicines |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Frail elderly, Pharmaceutical services, Drug therapy, Geriatrics, Randomized controlled trial, Hospitals, teaching