Discharge of multimorbid elderly hospital patients Not Applicable Discharge of multimorbid elderly hospital patients
Conditions
Interventions
Randomisation on the level of senior hospital physicians (= clusters) is done using a software random number generator. A minimization approach is used to restrict potential imbalance between the two
Sponsors
University Hospital of Zurich
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. In-hospital patient at the time of inclusion 2. Male or female of 60 years or older with 5 or more drugs prescribed 3. Signed informed consent or – in case of a patient incapable of judgement – written consent of a representative according to the Swiss law (fulfillment of the criteria laid down in HFG Art. 24, 1a.-c. with a legal representative according to ZGB Art. 378)
Exclusion criteria
Exclusion criteria: 1. End-stage disease with a life expectancy below 3 months 2. Cognitive inability to follow study procedures neither independently nor with assistance 3. Hospitals who took part in the Swiss national pilot project “progress! Sichere Medikation an Schnittstellen” will not be considered for participation in the trial (but may be involved in the pilot phase of the study).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Time (in days) without readmission to hospital is collected using Patient records (patient questionnaires and/or calls, general practitioner records, hospital records, health insurance company records) and consecutive calculation, within 6 months after discharge | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Readmission rates are collected using patient records (patient questionnaires and/or calls, general practitioner records, hospital records, health insurance company records) within 1, 3 and 6 months after discharge 2. Numbers of emergency department visits or general practitioner encounters are measured using patient records (questionnaires and/or calls, general practitioner records, hospital/emergency department records, health insurance company records) within 1, 3 and 6 months after discharge 3. Deaths during follow-up of 6 months are measured using patient records (general practitioner records, hospital records, health insurance company records) 4. Reasons for hospital readmission (when applicable), emergency department visits, general practitioner encounters or death are measured using patient records (questionnaires and/or calls, general practitioner records, hospital/emergency department records, health insurance company records) 5. Numbers of drugs at discharge and at 1, 3 and 6 months after discharge are measured using hospital records at discharge and patient records and/or calls (general practitioner records, health insurance company records) 6. Anatomical therapeutic chemical classes (ATC-codes) of the drugs prescribed/de-prescribed at discharge and at 1, 3, and 6 months after discharge are measured using hospital records at discharge and patient records and/or calls (general practitioner records, health insurance company records) and consecutive classification at study center 7. Proportions of potentially inappropriate medications (PIMs) at discharge and at 1, 3 and 6 months after discharge are measured using hospital records at discharge and patient records and/or calls (general practitioner records, health insurance company records) and consecutive classification at study center based on updated Beers criteria (2012) and PRISCUS list 8. P | — |
Countries
Switzerland
Contacts
Public ContactThomas;Stefan Grischott;Zechmann
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Outcome results
None listed