Optimizing Drug-Therapy in Patients 80 Years and Older

Study Overview
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Brief Summary
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The purpose of this study is to measure the effects of an enhanced service where a pharmacists is part of the healthcare team on the ward (focusing on drug-related problems and transferring information between primary and secondary care). Primary outcome measure is visits to hospital during a 12-month follow-up period, and the population is patients 80 years and older.

Detailed Description
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Optimising drug-therapy for patients, 80 years and older, to reduce hospital visits Background and Objective: Results from a pilot-study performed in 2004 at the Academic Hospital, Uppsala, including 214 consecutive patients (80 years old or older) showed that 9.4%-13.6% of the patients were acutely admitted to hospital due to a drug related problem1. Other similar international studies show that the frequency of drug-related hospital admissions stands for at least 14% of the acute admissions (14%-30.4%). Of these admissions it was estimated that 32%-69% were preventable 2,3,4. A study from Antrim Hospital, Northern Ireland, showed that pharmacists´ involvement in the health care team can reduce the number of acute hospital admissions and improve quality of drug use5. In view of these findings this study was initiated in 2005 with fundings from the Drug and Therapeutics committee, the County Council of Uppsala, the Division of Acute-Medicine and the Pharmacy Department at the Academic Hospital in Uppsala Aim and objectives: The Study Aim was to optimize drug-prescribing and drug use for patients 80 years and older. The main objective was to reduce the number of hospital visits for patients 80-years old or older. Design: A randomized, controlled trial including 400 patients (200+200). Patients in the intervention group (I) received a patient interview on admission, drug counseling on discharge and a drug review - all performed by a clinical pharmacist. Patients in the control group (C) received standard care, without pharmacists´ involvement. Patients were included between Oct 2005 and June 2006. Setting: Two wards at the Division of Acute-Medicine at Uppsala University Hospital, Sweden Main Outcome Measures: 1) Frequency of hospital visits 12 months after (last included patient) discharge from hospital for (I) and (C).

Official Title
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Optimizing Drug-Therapy in Patients, 80 Years and Older, in Order to Reduce Drug-Related Morbidity and Usage of Secondary Care - a Randomized Controlled Trial

Conditions
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Drug-Related Problems

Intervention / Treatment
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* Other: Drug review 80+ -To reduce usage of hospital care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 80 years and older Acute admission to study ward Exclusion Criteria: <80 years Scheduled admission Previously admitted to studyward during study period

Ages Eligible for Study
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Minimum Age: 80 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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: I<br>Intervention by team consisting of Doctor, pharmacist and nurse | Other: Drug review 80+ -To reduce usage of hospital care<br>* drug review performed by multiprofessional team, including clinical pharmacist, in order to optimize drug therapy and reduce usage of hospital care. Also patient education and follow-up<br>|
| No Intervention: C<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effects on hospital visits |  | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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re-admissions, medicines, management, patients, 80 years and older, acute, admissions, hospital