Clinical trial NCT02165618: Rationalisation of Polypharmacy by the Geriatric Consultation Team
Official title: Rationalisation of Polypharmacy by the Geriatric Consultation Team Using the RASP List: a Pilot Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Iatrogenic Disease
Keywords: frailty
geriatric, elderly
polypharmacy
Lead sponsor: Universitaire Ziekenhuizen KU Leuven
Sponsor class: OTHER
First posted: 2014-06-17
Enrollment: 60
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

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.

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

Primary outcomes:
measure: Number of medication-related recommendations by the geriatric consultation team.
timeFrame: The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days.
Secondary outcomes:
measure: Number of potentially inappropriate drugs at discharge, as identified by the RASP list.
timeFrame: The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days.
measure: Number of drugs at discharge, relative to the drugs on admission.
timeFrame: The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days.
measure: Acceptance rate of the GCT interventions by the treating physician.
timeFrame: Up to 72 hours after the GCT had given its recommendations.
Other outcomes:
Locations:
city: Leuven
country: Belgium
facility: University Hospitals Leuven
state: Flemish Brabant
Study officials:
affiliation: Universitaire Ziekenhuizen KU Leuven
name: Lorenz R Van der Linden, PharmD
role: PRINCIPAL_INVESTIGATOR
affiliation: Universitaire Ziekenhuizen KU Leuven
name: Johan Flamaing, MD, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Universitaire Ziekenhuizen KU Leuven
name: Jos Tournoy, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Van der Linden L, Hias J, Dreessen L, Milisen K, Flamaing J, Spriet I, Tournoy J. Medication review versus usual care to improve drug therapies in older inpatients not admitted to geriatric wards: a quasi-experimental study (RASP-IGCT). BMC Geriatr. 2018 Jul 3;18(1):155. doi: 10.1186/s12877-018-0843-y.