Elderly, Polypharmacy
Conditions
Brief summary
Objective: To evaluate the clinical and economic impact of the application of an algorithm to improve the adequacy and safety of pharmacotherapy in elderly polymedicated (receiving 8 or more medications), not institutionalized. Design: randomized, open, multicenter and two branches of parallel intervention clinical trial. Intervention Study: primary care pharmacist apply the GP-GP algorithm to each drug with the support of STOPP criteria, Beers and / or recommendations CatSalut. The pharmacist submit to doctor his findings and reach a consensus and decide which recommendations will be presented to patient. Control intervention: usual procedure. Main outcome measures: a) Discontinued medications, changed or changing doses, b) GP consultations, hospital emergency department and hospital admissions for acute illness, c) pharmaceutical expenditure, d) restart medication e) complications underlying diseases. Follow-up control at 1 month (security) and at 3, 6 and 12 months.
Interventions
PROCEDUREPharmacist Intervention
Sponsors
Consorci Sanitari del Maresme
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 70 years or more * Currently receiving eight or more drugs, except ointments and administered via topical nonprescription * Give their informed written consent to participate in the study.
Exclusion criteria
* Estimated life expectancy less than 6 months. * Active cancer * Participation in any other clinical trial or program for evaluation of medication in the elderly. * Institutionalized in nursing homes. * Surgical intervention scheduled for the next 6 months
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of patients with medications discontinued, reduced dose or changed. | baseline, 3, 6 and 12 months |
| Number of discontinued medications, changed or changing doses. | baseline, 3, 6 and 12 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of life | baseline, 3 and 6 months | EuroQoL questionnaire |
| Pharmaceutical recommendations acceptance rate | baseline | — |
| Resumption of medication | 3, 6 and 12 months | — |
| Mortality | 3, 6 and 12 months | — |
| Healthcare resource consumption | 3, 6 and 12 months | Number of visits to Primary care center, Number of visits to hospital emergency department, Number of hospital admission, Number of outpatients hospital visits. |
| Medication adherence | baseline, 3 and 6 months | Morisky-Green questionnaire |
Outcome results
None listed