Clinical trial NCT00738816: Effect of Systematic Medication Review in Elderly Patients Admitted to an Orthopedic Department
Official title: The Effect of Systematic Medication Review in Elderly Patients Admitted to an Orthopedic Department.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Elderly
Keywords: Medication review
Patient
Safety
Drug
Prescriptions
Drug-use
Lead sponsor: University of Aarhus
Sponsor class: OTHER
First posted: 2008-08-21
Enrollment: 108
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Elderly patients have a higher risk of experiencing adverse drug events due to an age related increase in morbidity and medication use. Inappropriate or wrong medication use among elderly patients acutely admitted to hospitals is assumed to result in earlier contact to general practitioner, emergency departments and re-admissions if not corrected during hospital admission. It is therefore our hypothesis that a systematic medication review conducted by pharmacists and physicians specialized in pharmacology will increase time to first unscheduled physician contact (general practitioner, emergency departments, ambulatory care and re-admissions) after discharge from hospital from an average of 21days to 25 days. Further, the following secondary outcome parameters will be measured at discharge and within 3-month follow-up:

* length of in-hospital stay
* number of contacts to general practitioner 30 days after discharge, that resulted in medication changes
* number of re-admissions at 3-month
* number of death at 3-month
* number of contact to primary health care at 3-month
* patients self-experienced quality of health(EQ-5D) 3-month


Eligibility criteria: Inclusion Criteria:

* age 65 years or older
* expected admission time of more than 24 hours
* acute admission

Exclusion Criteria:

* Psychotic patients
* Moribund patients
* Suicidal patients

Primary outcomes:
measure: Time to first unscheduled physician contact(general practitioner,emergency department, ambulatory care or re-admission to hospital) after discharge from the Orthopaedic Department
timeFrame: January 2010
Secondary outcomes:
measure: Admission time
timeFrame: October 2009
Other outcomes:
Locations:
city: Randers
country: Denmark
facility: Regional hospital, Randers
state: Central Denmark Region
Study officials:
affiliation: Aarhus University Hospital, Denmark
name: Nielsen Lars Peter, Assoc. Prof.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol. 2008 Mar;65(3):303-16. doi: 10.1111/j.1365-2125.2007.03071.x. Epub 2007 Dec 17.
citation: Lau HS, Florax C, Porsius AJ, De Boer A. The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards. Br J Clin Pharmacol. 2000 Jun;49(6):597-603. doi: 10.1046/j.1365-2125.2000.00204.x.
citation: Glintborg B, Andersen SE, Dalhoff K. Drug-drug interactions among recently hospitalised patients--frequent but mostly clinically insignificant. Eur J Clin Pharmacol. 2005 Oct;61(9):675-81. doi: 10.1007/s00228-005-0978-6. Epub 2005 Oct 19.
citation: Page RL 2nd, Ruscin JM. The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use. Am J Geriatr Pharmacother. 2006 Dec;4(4):297-305. doi: 10.1016/j.amjopharm.2006.12.008.
citation: Vira T, Colquhoun M, Etchells E. Reconcilable differences: correcting medication errors at hospital admission and discharge. Qual Saf Health Care. 2006 Apr;15(2):122-6. doi: 10.1136/qshc.2005.015347.