Clinical trial NCT05816967: Rationalisation of Polypharmacy by the RASP-instrument and Discharge Counselling of Geriatric Inpatients
Official title: Rationalisation of Polypharmacy by the RASP-instrument (Rationalisation of Home Medication by an Adjusted STOPP-list and Discharge Counselling of Geriatric Inpatients: a Prospective, Clinical Trial
Study type: INTERVENTIONAL
Overall status: WITHDRAWN
Phase: NA
Conditions: Polypharmacy
Lead sponsor: Universitaire Ziekenhuizen KU Leuven
Sponsor class: OTHER
First posted: 2023-04-18
Enrollment: 0
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: SUPPORTIVE_CARE

Brief summary: Systematic evaluation of polypharmacy in geriatric patients, through a validated list by a clinical pharmacist. The goal is reduction of potentially inappropriate medications (PIMs). A brief counseling session with the patient and/or his/her caregiver will be part of the intervention.

Detailed description: This project is focused on the systematic evaluation of polypharmacy in older patients admitted to the acute geriatric wards of a university hospital. Polypharmacy will be identified through a validated list by a clinical pharmacist. The goal is reduction of potentially inappropriate medications (PIMs). Before hospital discharge the hospital pharmacist will have a brief counseling session with the patient and/or his/her caregiver in order to discuss the medication list and to enhance compliance.

Eligibility criteria: Inclusion Criteria:

* Informed consent by the patient and/or his/her caregiver
* Admission through the emergency department of patients coming from home or a residential care facility

Exclusion Criteria:

* Patients not speaking Dutch
* Patients admitted for end of life care
* Patients not taking any drugs on admission

Primary outcomes:
measure: Acceptance rate of the pharmacotherapeutic recommendations, provided by the clinical pharmacist by the general practitioner.
timeFrame: 1 month (30 days) after discharge
measure: Acceptance rate of the pharmacotherapeutic recommendations, provided by the clinical pharmacist by the general practitioner.
timeFrame: 3 month (90 days) after discharge
Secondary outcomes:
measure: Number of drug intakes at discharge versus at admission.
timeFrame: At discharge from the index hospitalization (as mentioned in the discharge medication scheme) vs on admission (during the first 72 hours of the index hospitalization)
measure: Number of drugs at discharge versus at admission.
timeFrame: At discharge from the index hospitalization (as mentioned in the discharge medication scheme) vs on admission (during the first 72 hours of the index hospitalization)
measure: Number of drugs adapted by the treating physician based on recommendations by the clinical pharmacist that are not included in the RASP list.
timeFrame: At discharge from the index hospitalization (as mentioned in the discharge medication scheme), compared to the medication list obtained on admission (this is, during the first 72 hours of the hospitalization)
measure: Difference in number of potentially inappropriate medications identified through the RASP list on admission versus at discharge
timeFrame: At discharge from the index hospitalisation (as mentioned in the discharge medication scheme) versus on admission (medication list obtained in the first 72 hours) of the index hospitalization
measure: Number of potentially inappropriate medications on admission, at discharge and at the follow-up moments (1 and 3 months after discharge)
timeFrame: On admission (medication list obtained in the first 72 hours of the admission), at discharge (as mentioned in the discharge medication scheme), 1 (30 days) month after discharge, 3 months (90 days) after discharge
measure: Mortality during admission
timeFrame: During the index hospitalization, from admission to the emergency ward until moment of death on the geriatric ward, assessed up to 72 hours after death.
measure: Number of falls during hospitalization
timeFrame: During the index hospitalization, from admission on the emergency ward until discharge from the geriatric ward, assessed within 72 hours after discharge.
measure: Number of fractures during hospitalization
timeFrame: during the index hospitalization, from admission to the emergency ward until discharge from the geriatric ward, assessed within 72 hours after discharge.
measure: Length of stay
timeFrame: During the index hospitalization, from admission to the emergency ward until discharge from the geriatric ward, assessed within 72 hours after discharge.
measure: Readmission rate 3 months after discharge
timeFrame: 3 months (90 days) after discharge from the geriatric ward (index hospitalization), assessed at day 90
measure: Number of fractures at 3 months after discharge
timeFrame: 3 months (90 days) after discharge from the geriatric ward (index hospitalization), assessed at day 90
measure: Number of falls 3 months after discharge
timeFrame: 3 months (90 days) after discharge from the geriatric ward (index hospitalization), assessed at day 90
measure: Mortality at 3 months after discharge
timeFrame: 3 months (90 days) after discharge from the geriatric ward (index hospitalization), assessed at day 90
measure: Category of potentially inappropriate medications identified through the RASP list on admission and at discharge
timeFrame: On admission (medication list obtained in the first 72 hours of the admission), at discharge (as mentioned in the discharge medication scheme)
measure: Category of drugs adapted by the treating physician based on recommendations by the clinical pharmacist that are not included in the RASP list.
timeFrame: During the course of the index hospitalization, defined as the period between discharge from the geriatric ward and admission to the geriatric department. The outcome parameter will be assessed within 72 hours of discharge.
measure: Number of drugs at follow-up (1 month and 3 months after discharge)
timeFrame: 1 month (30 days) and 3 months (90 days) after the index hospitalization
measure: Number of drug intakes at follow-up (1 month and 3 months after discharge)
timeFrame: 1 month (30 days) and 3 months (90 days) after the index hospitalization
Other outcomes:
Locations:
city: Leuven
country: Belgium
facility: UZLeuven
Study officials:
affiliation: UZ Leuven
name: Julie Hias, Pharm D
role: PRINCIPAL_INVESTIGATOR
References: