Clinical trial NCT01947270: Multidisciplinary Program "Optimization of Drug Prescription" : Impact on the Quality of Drug Prescription in Hospitalized Elderly Patients
Official title: OPMED STUDY: Multidisciplinary Program "Optimization of Drug Prescription" : Impact on the Quality of Drug Prescription in Hospitalized Elderly Patients
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Potentially Inappropriate Medications
Keywords: Potentially inappropriate medications
Elderly
Prevention
Multidisciplinary program
Checklist
Stepped wedge design
AGED, 75 AND OVER
Lead sponsor: Hospices Civils de Lyon
Sponsor class: OTHER
First posted: 2013-09-20
Enrollment: 3055
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Hospitalized elderly patients from 75 years old.

Brief summary: Drug prescription is a fundamental component of care for the elderly. Even if drugs are a chance for the older patient, because of changes in pharmacological, pharmacokinetic and pharmacodynamic parameters related with age and acute/or chronic pathologies, the risks associated with drug prescription, particularly those associated with potentially inappropriate medication (PIM), are increased in the elderly.

We suppose that many of hospitalized elderly have at least one prescribed medication without valid indication. Conversely, many diseases are currently undertreated in elderly patients: e.g. medicines used to treat heart failure and osteoporosis are underused in 20 to 70% of patients. Moreover, PMI prescription is associated with an increased of morbidity, mortality, risk of drug-related adverse events, utilization of health care system, care costs and impairment of quality of life. Thus, optimization of drug prescription is a major concern for improvement of the quality and safety of care in elderly.

The investigators' hypothesis is that a multidisciplinary program entitled "Optimisation de la Prescription MEDicamenteuse" ("Optimization of drug prescribing") focused on drug prescription optimization including a physician training to the specificity of the drug prescription in the elderly and a checklist allowing an adapted and standardized pharmaceutical analysis is effective in reducing PIM in elderly patients hospitalized in short-term medical and geriatric care departments.


Eligibility criteria: Inclusion Criteria:

* Male or female subject aged over 75 years hospitalized in one of the participating department
* Patient agreed to participate

Exclusion Criteria:

* Patient with a predictive length of stay equal or less than 48 hours
* Patients admitted in terminal illness

Primary outcomes:
measure: Proportion of potentially inappropriate medications (PIM) prescribed in discharge of hospitalized patients from 75 years old.
timeFrame: at discharge (average 3 weeks)
Secondary outcomes:
measure: Total number of drugs prescribed per discharge prescription sheet
timeFrame: at discharge (average 3 weeks)
measure: Number of rehospitalization within 12 months following discharge
timeFrame: 12 months after inclusion
measure: Number of emergency admission within 12 months following hospitalization
timeFrame: 12 months after inclusion
measure: Mortality within 12 months after hospitalization
timeFrame: 12 months after inclusion
Other outcomes:
Locations:
city: Lyon
country: France
facility: Hospices Civils de Lyon - Hôpital Edouard Herriot
Study officials:
References: