polyfarmacie Hyperpolypharmacy
Conditions
Interventions
A comprehensive PGx-guided medication review by a multidisciplinary team and 
consultation by a clinical pharmacist.
Sponsors
Maasstadziekenhuis
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: - admission to Antes medical psychiatric unit or the internal medicine wards of the Maasstad hospital - age >= 18 years - >= 10 systemic drugs (concomitant use) - medication reconciliation at admission - informed consent
Exclusion criteria
Exclusion criteria: - previous whole genome genetic testing - life expectancy < 6 months - expected admission duration < 5 days (to facilitate acting upon the PGx results) - if the clinician considers the patient to be mentally incompetent in decision making
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| This cross-sectional intervention study aims to situate comprehensive PGx-guided therapeutic management in a clinical setting. To this end, we will quantify the actionable DGIs in a clinical population. Actionable DGIs are defined by the currently known literature (i.e. KNMP, DPWG, PharmVAR, CPIC, and PharmGKB). | — |
Secondary
| Measure | Time frame |
|---|---|
| In addition, the secondary objectives of this study are to evaluate the resulting pharmacotherapeutic optimizations and the adopted recommendations. | — |
Countries
Netherlands
Outcome results
None listed