Frail Elderly, Poly Pharmacy
Conditions
Keywords
polypharmacy, frailty, adverse drug event, deprescribing
Brief summary
The goal of this clinical trial is to learn if a multi-professional (conducted by geriatricians, clinical pharmacists, nurses) medication revision, centered on patients' goals and characteristics, can improve treatment adequacy in older adults admitted to an intermediate care hospital. The main question it aims to answer is: does this approach reduce the average number of medications taken per patient? Researchers will compare this multi-professional patient-centered revision to the usual standard of care (treatment revision conducted by a clinical pharmacist) to see if the patient-centered revision works in improving treatment adequacy. Participants admitted to an intermediate care hospital will undergo a comprehensive assessment by a geriatrician, and a medication revision (conducted by a multidisciplinary team or a clinical-pharmacist alone). They will also be asked to fulfill some questionnaires on their health status and attitudes. Any possible adverse events to the medications will be recorded at discharge. Participants will be contacted again three months after discharge to check for any readmission or death.
Interventions
OTHERPatient-centered multidisciplinary treatment review
Patient-centered multidisciplinary treatment review is defined as a medication review conducted by a multidisciplinary team (geriatrician, clinical pharmacist, nurse) according to a patient-centered methodology, based on person-centered evaluation of both personal and clinical insights, diagnostic-centered evaluation (based on current guidelines), and drug-centered evaluation (based on adequacy)
Sponsors
Parc Sanitari Pere Virgili
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Stepped-wedge
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* older adults (65+ years) * ≥ 3 or more chronic conditions requiring medical therapy * able to speak Spanish * capacity to provide informed consent or have a surrogate able to consent on their behalf
Exclusion criteria
* unable to provide informed consent * anticipated length of hospital stay \< 72h * estimated life expectancy \< 3 months * homeless * already enrolled in a drug trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of drugs | Baseline and after discharge, an average of 30 days | Median number of drugs per patient |
Countries
Spain
Contacts
Primary ContactAna M de Andrés Lázaro, Pharmacist. PhD
Outcome results
None listed