Clinical trial NCT00279656: Benefit of a Collaborative Approach to Improve the Quality of Medicines Use in Elderly Inpatients
Official title: Collaborative Approach to Improve the Quality of Medicines Use in Elderly Inpatients - Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Frail Elderly Inpatient
Keywords: Frail elderly
Pharmaceutical services
Drug therapy
Geriatrics
Randomized controlled trial
Hospitals, teaching
Lead sponsor: Université Catholique de Louvain
Sponsor class: OTHER
Collaborators: name: Fonds National de la Recherche Scientifique
First posted: 2006-01-19
Enrollment: 180
Sex: ALL
Minimum age (years): 70
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: ECT

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: 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 outcomes:
measure: Polymedication on admission, at discharge, and 1,3,12 months after discharge
measure: Mortality, readmission to hospital and visit to the emergency department 1,3,12 months after discharge
measure: Satisfaction with information received on medicines
Other outcomes:
Locations:
city: Brussels
country: Belgium
facility: Université catholique de Louvain
Study officials:
affiliation: Université Catholique de Louvain
name: Anne Spinewine, MSc
role: PRINCIPAL_INVESTIGATOR
affiliation: Université Catholique de Louvain
name: Christian Swine, MD
role: STUDY_CHAIR
affiliation: Université Catholique de Louvain
name: Paul M Tulkens, PhD
role: STUDY_DIRECTOR
References: