Patients who are over 65 and prescribed at least one potentially inappropriate medicine where the likely harms outweigh the benefits. Other
Conditions
Interventions
Current interventions as of 03/07/2025:
This is a stepped wedge trial (with an internal pilot study) of a deprescribing behaviour change intervention targeting geriatricians and pharmacists caring for
Sponsors
University of Leicester
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Current inclusion criteria as of 11/10/2024: Practitioner inclusion criteria: Consultant Geriatrician or Specialist Registrar and appropriately qualified Pharmacist working across Older People’s Medicine wards Patient inclusion criteria: All patients receiving treatment in the study wards within the study window and under the care of a participating Geriatrician. Previous inclusion criteria: Practitioner inclusion criteria: Consultant Geriatrician or Specialist Registrar and appropriately qualified Pharmacist working across Older People’s Medicine wards Patient inclusion criteria: All patients receiving treatment in the study wards within the study window
Exclusion criteria
Exclusion criteria: Current exclusion criteria as of 11/10/2024: Practitioner exclusion criteria: Less than 0.3 FTE of ward-based time Patient exclusion criteria: Not under the care of a participating Geriatrician Previous exclusion criteria: Practitioner exclusion criteria: Less than 0.3 FTE of ward-based time
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Patient readmission to the hospital measured using Hospital Episode Statistics (HES) data 90 days post hospital discharge | — |
Secondary
| Measure | Time frame |
|---|---|
| Patient-oriented secondary outcomes measures: 1. Mortality is measured using the Office of National Statistics (ONS) records 90 days post-hospital discharge 2. The number of hospital stays post-discharge is measured using Hospital Episode Statistic (HES) data 90 days post-hospital discharge 3. Quality of life is measured using the EuroQol EQ-5D-5L validated questionnaire at discharge and 90 days post-hospital discharge 4. Satisfaction with deprescribing is measured using a 13-item bespoke questionnaire as soon as possible post-hospital discharge Process secondary outcomes measures: 1. Number of regularly prescribed medicines at the point of leaving the ward is measured using site medical records at discharge 2. Number of prescribed medicines for ‘when required use’ at the point of leaving the ward is measured using hospital site medical records at discharge 3. Number of prescribed medicines that are stopped is measured using hospital-site medical records at discharge 4. Number of prescribed medicines with dosage reduced is measured using hospital site medical records at discharge 5. Number of stopped medicines that are restarted within three months of discharge is measured using community pharmacy dispensed medicines data 6. 90 days post-hospital discharge Economic secondary outcomes measures: 1. Costs/resource use for the intervention is measured using the fidelity framework/expert-opinion/study records during active study periods 2. Length of hospital stay for index admission is measured using site medical records at hospital discharge 3. Number of admissions in the follow-up period is measured using routine data at the end of the study | — |
Countries
England, United Kingdom
Contacts
Public ContactCHARMER Study Team
Outcome results
None listed