Potentially Inappropriate Medications | Multidisciplinary Program "Optimization of Drug Prescription" : Impact on the Quality of Drug Prescription in Hospitalized Elderly Patients
Potentially Inappropriate Medications research study
What is the primary objective of this study?
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.
Who is eligible to participate?
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
Which medical condition, disease, disorder, syndrome, illness, or injury is researched?
Potentially Inappropriate Medications
Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.
Other:" Optimisation de la Prescription MEDicamenteuse " ("Optimization of drug prescribing")The multidisciplinary intervention program include: Awareness and training of doctors by two experts (a geriatrician and a pharmacist) within participating departments. Implementation of a checklist which aims to conduct an adapted and standardized pharmaceutical analysis
Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.
Control groupPatients of this group are hospitalized in a time frame where the multidisciplinary intervention program is not implemented in the medical department. Drug prescriptions are conducted under usual care in the department.
Intervention groupPatients of this group are hospitalized in a time frame where the multidisciplinary intervention program is implemented in the medical department.
Start Date: January 2013
Completed Date: June 2017
Primary Outcome: Proportion of potentially inappropriate medications (PIM) prescribed in discharge of hospitalized patients from 75 years old.
Secondary Outcome: Total number of drugs prescribed per discharge prescription sheet
Study sponsors, principal investigator, and references
Lead Sponsor: Hospices Civils de Lyon