Diabetes Complications, Gastrointestinal Hemorrhage, Multimorbidity
Conditions
Keywords
multimorbidity, multiple chronic conditions, drug-drug interactions, drug-disease interactions, polypharmacy, Oral anticoagulants, Steroids
Brief summary
Clinical practice guidelines do not take into account multimorbidity and various potential therapeutic conflicts. Identifying and quantifying therapeutic conflicts is crucial in multimorbid patients having more than two acute or chronic diseases. Guidance should be available for frequent encountered situations, e.g. gastrointestinal bleeding or exacerbation of diabetes mellitus.
Detailed description
The study investigates multimorbidity in view of the occurrence of two different therapeutic conflicts or dilemma situations, respectively. The first concerns patients with diagnosis of gastrointestinal bleeding and prescription of anticoagulants or/and antiplatelet drugs (e.g., warfarin, clopidogrel and acetylsalicylic acid) as a risk factor for bleeding events. The second concerns patients with diagnosis of exacerbated diabetes mellitus and prescription of corticosteroids as a risk factor for worsening of blood glucose.
Interventions
OTHERdrug-drug or drug-disease interaction
Sponsors
University Hospital, Zürich
Center of Competence Multimorbidity, Zurich
University of Zurich
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Inpatients at the University Hospital Zurich, USZ * Male and female patients, aged 18 years or older * Fulfilling the criteria for Use Case A or B (i.e. patients with gastrointestinal bleeding and anticoagulants or antiplatelet drugs, Use Case A or patients with diabetes mellitus and/or systemic corticosteroids, Use Case B)
Exclusion criteria
* If potential participants have a statement in the electronic medical record or elsewhere to refuse study participation, this represents
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patients with gastrointestinal bleeding and anticoagulants or antiplatelet drugs | 5 years | Do anticoagulants or antiplatelet drugs increase the risk of repeated bleeding in patients with gastrointestinal bleeding? |
| Patients with diabetes mellitus and systemic corticosteroids | 5 years | Do systemic corticosteroids increase the risk of exacerbation in patients with diabetes mellitus? |
Countries
Switzerland
Outcome results
None listed