Clinical trial NCT05944328: Effectiveness of an Intervention of Pharmacotherapeutic Plans to Reduce Medication-related Problems in Geriatric Residences
Official title: Effectiveness of a Structured Pharmaceutical Review Intervention of Pharmacotherapeutic Plans to Reduce Medication-related Problems in Geriatric Residences: a Quasi-experimental Pragmatic Assay
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Polypharmacy
Keywords: pharmaceutical intervention
polypharmacy
nursing home
Lead sponsor: Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina
Sponsor class: OTHER
First posted: 2023-07-13
Enrollment: 862
Sex: ALL
Minimum age (years): 65
Maximum age (years): 110
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: Background: Patients living in Geriatric Residences (RG) have increased aging, comorbidity, spending on health resources and mortality. High drug use is associated with an increased risk of falls, disability, and death. It is estimated that 20-50% of inappropriate medications are consumed in the elderly.

Hypothesis: A pharmaceutical intervention based on a clinical review of the pharmacotherapeutic plan of patients in RG will be useful in optimizing the prescription in terms of safety, reducing by 10% or more the inappropriate prescriptions.

Objectives: Evaluate the effectiveness of a structured pharmaceutical intervention based on the clinical review of the pharmacotherapeutic plan to improve its adequacy.

Decrease inadequate prescriptions in patients admitted to RG by 10%

Methodology: Pre-post, quasi-experimental intervention study with control group with prospective follow-up of a cohort of patients in RG. The intervention consists of the clinical review of the pharmacotherapeutic plan carried out by the pharmacist and subsequently agreed in the Pharmacotherapeutic Advisory Committee.

Determinations: The study variables will be evaluated at baseline and 3 months post-intervention. The primary variable is number of inappropriate prescriptions.

Statistical analysis: Percentage change will be measured before and after the intervention. Descriptive statistics will be performed for quantitative variables such as qualitative and comparison of means and proportions.

Expected results: Achieve a 10% decrease in inappropriate prescriptions

Applicability and Relevance: This study will expand the collaboration between the Pharmacy and Primary Care physicians, promoting the continuum of care, strengthening the safety culture, and improving prescribing habits.


Eligibility criteria: Inclusion Criteria:

* Age 65 years or older
* Pharmacological treatment with at least one drug and for a period of more than three months

Exclusion Criteria:

* Individuals who at the time of the pharmaceutical review were in hospital
* Patients nearing the end of life
* Patients whose participation was considered by the doctor responsible to be potentially detrimental
* Patients not covered by the public healthcare or pharmacy system were excluded.

Primary outcomes:
measure: Drug-related problems
timeFrame: Basal
measure: Drug-related problems
timeFrame: Three months
measure: Drug-related problems
timeFrame: Basal
measure: Drug-related problems
timeFrame: Three months
measure: Drug-related problems
timeFrame: Basal
measure: Drug-related problems
timeFrame: Three months
measure: Polymedication:
timeFrame: Basal
measure: Polymedication:
timeFrame: Three months
measure: Polymedication:
timeFrame: Basal
measure: Polymedication:
timeFrame: Three months
Secondary outcomes:
measure: Sociodemographic variables
timeFrame: Basal
measure: Sociodemographic variables
timeFrame: Basal
measure: Sociodemographic variables
timeFrame: Basal
measure: Description and classification of the DRPs detected Description and classification of the DRPs detected
timeFrame: Basal
measure: Description and classification of the DRPs detected Description and classification of the DRPs detected
timeFrame: Basal
measure: Description and classification of the DRPs detected Description and classification of the DRPs detected
timeFrame: Basal
measure: Description and classification of the DRPs detected Description and classification of the DRPs detected
timeFrame: Basal
measure: Description and classification of the DRPs detected Description and classification of the DRPs detected
timeFrame: Three months
measure: Description and classification of the DRPs detected Description and classification of the DRPs detected
timeFrame: Three months
measure: Description and classification of the DRPs detected Description and classification of the DRPs detected
timeFrame: Three months
measure: Description and classification of the DRPs detected Description and classification of the DRPs detected
timeFrame: Three months
Other outcomes:
Locations:
city: Tarragona
country: Spain
facility: Cecilia Campabadal Prats
Study officials:
References: