Polymedication of elderly risk patients
Conditions
Interventions
Group 1: Control group: a Status Quo Survey will be conducted (time of inclusion about 9 months)
Group 2: Intervention group: clinical pharmacist will perform an additional medication anamnesis with t
entering of the medication into the electronic prescription software (in communication with the ward physician)
in case of DRP and PIM contact with the general practitioner and written recommendations on how to possibly optimise the medication
use of the national medication plan ("Bundeseinheitlicher Medikationsplan") (time of inclusion about 9 months, duration of the study for each patient about 4 months, control and intervention phase wil
Sponsors
Klinik und Poliklinik für Anästhesiologie
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: - patients of the University Medical Centre Hamburg-Eppendorf - age > 65 years - planned surgery in not less than 21 days - POSPOM-Score >20 (risk patients) - long-term medication >/= 5 drugs
Exclusion criteria
Exclusion criteria: - refusal of confession - emergency surgery - surgery with planned postoperative intensive medical care - cerebral and ophtalmological surgery as well as surgerys with planned inpatient care less than one day - drug abuse (intravenous, in medical history or current) - psychosis - chronically abuse of benzodiazepines - Parkinson's disease - illiteracy - blindness/deafness - poor knowledge of the German language - preexisting mental disorder
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Medication Appropriatness Index (MAI) - at T1 (patients’ initial visit), T3 (after admission to hospital), T4 (immediately after discharge from hospital) and T5 (three months after discharge) | — |
Secondary
| Measure | Time frame |
|---|---|
| - Occurrence of postoperative complications - Correct recording of the medication at the interfaces (Medication Reconciliation) - satisfaction with medical care (outpatient: ZAPA/ inpatient: ZUF-8) - occurrence and frequency of DRP and PIM - health-related quality of life (SF-12) - treatment adherence (MARS-D) | — |
Countries
Germany
Contacts
Public ContactCynthia Olotu
Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Anästhesiologie
Outcome results
None listed