Geriatric
Conditions
Brief summary
To evaluate the impact of clinical pharmacist-led appropriate acid suppression therapy stewardship program in hospitalized older patients.
Detailed description
This prospective, nonrandomized controlled study was conducted in older patients who ordered proton pump inhibitor (PPI) at admission in an internal medicine service of tertiary training and research hospital. In the intervention group, clinical pharmacist-led services (including medication reconciliation and medication review) were conducted during hospitalization and at discharge by using the guidelines and potentially inappropriate medications (PIM) criteria \[American Geriatric Society-AGS Beers Criteria©, 2019\]. Medication Appropriateness Index (MAI), inappropriate PPI cost, and hospitalization for gastrointestinal bleeding within 1 year after discharge were calculated in both groups
Interventions
OTHERClinical Pharmacist-led Appropriate Acid Suppression Therapy Stewardship Program
Clinical pharmacist provided medication reconciliation and medication review during the hospital stay.
Sponsors
Marmara University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
* 65 years old or greater * Admitted to the hospital with any reason * Ordered at least one PPI dose within 48 hours of admission
Exclusion criteria
* Transferred to another ward (including an intensive care unit) * Having active gastrointestinal bleeding * Having active malignity
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Appropriateness of Proton Pump Inhibitors Usage | during hospital stay, an average of 14 days | The rate of appropriateness use of proton pump inhibitors based on the guidelines at hospital stay |
| Potentially Inappropriate Proton Pump Inhibitors Usage | at discharge, an average of 14 days after admission to hospital | The rate of potentially inappropriate use of proton pump inhibitors based on American Geriatric Society Beers Criteria© 2019 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Medication Appropriateness Index for Proton Pump Inhibitors at hospital stay | during hospital stay, an average of 14 days | Medication Appropriateness Index (MAI); included 10 items. Each item was weighted from 1-3. The highest score per medication was 18. Higher scores of this index represent more inappropriateness of each medication. |
| Clinical outcome | 1 year | The number of patients who hospitalized for bleeding within 1 year after discharge |
| Medication Appropriateness Index for Proton Pump Inhibitors at discharge | at discharge, an average of 14 days after admission to hospital | Medication Appropriateness Index (MAI); included 10 items. Each item was weighted from 1-3. The highest score per medication was 18. Higher scores of this index represent more inappropriateness of each medication. |
| Cost saving after discharge | a month | Medication cost for potentially inappropriate PPI after discharge |
| Cost saving during hospital stay | during hospital stay, an average of 14 days | Medication cost for inappropriate PPI during hospital study |
Countries
Turkey (Türkiye)
Outcome results
None listed