Effect of Systematic Medication Review in Elderly Patients Admitted to an Orthopedic Department

Elderly Clinical Trial

Official title:

The Effect of Systematic Medication Review in Elderly Patients Admitted to an Orthopedic Department.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00738816
• Other study ID #: Klinfarm
• Status: Completed
• Phase: N/A
• First received: August 20, 2008
• Last updated: December 13, 2010
• Start date: April 2009
• Est. completion date: April 2010

Study information

• Verified date: December 2010
• Source: University of Aarhus
• Contact: n/a
• Is FDA regulated: No
• Health authority: Denmark: Danish Dataprotection AgencyDenmark: The Danish National Committee on Biomedical Research Ethics
• Study type: Interventional

Clinical Trial Summary

Elderly patients have a higher risk of experiencing adverse drug events due to an age related increase in morbidity and medication use. Inappropriate or wrong medication use among elderly patients acutely admitted to hospitals is assumed to result in earlier contact to general practitioner, emergency departments and re-admissions if not corrected during hospital admission. It is therefore our hypothesis that a systematic medication review conducted by pharmacists and physicians specialized in pharmacology will increase time to first unscheduled physician contact (general practitioner, emergency departments, ambulatory care and re-admissions) after discharge from hospital from an average of 21days to 25 days. Further, the following secondary outcome parameters will be measured at discharge and within 3-month follow-up:

• length of in-hospital stay

• number of contacts to general practitioner 30 days after discharge, that resulted in medication changes

• number of re-admissions at 3-month

• number of death at 3-month

• number of contact to primary health care at 3-month

• patients self-experienced quality of health(EQ-5D) 3-month

Recruitment information / eligibility

• Status: Completed
• Enrollment: 108
• Est. completion date: April 2010
• Est. primary completion date: February 2010
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

• age 65 years or older

• expected admission time of more than 24 hours

• acute admission

Exclusion Criteria:

• Psychotic patients

• Moribund patients

• Suicidal patients

Study Design

Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention

Related Conditions & MeSH terms

• Elderly

Intervention

Other:
• Systematic medication review and advisory notes
Within 24 hours of admission a pharmacist retrieve medication histories from patients included in the intervention group. Medication histories will be obtained from - medical records, medication charts, patients electronical medication profile, interview with patients and if necessary contact to the patients general practitioner. The obtained medication history will be discussed with a physician specialized in pharmacology and an advisory note with suggested changes to the patients medication is added to the medical record. The orthopedic physicians are not obliged to follow the suggested changes

Locations

Country	Name	City	State
Denmark	Regional hospital, Randers	Randers	Central Denmark Region

Sponsors (1)

Lead Sponsor	Collaborator
Aarhus University Hospital

Country where clinical trial is conducted

Denmark, 

References & Publications (5)

Glintborg B, Andersen SE, Dalhoff K. Drug-drug interactions among recently hospitalised patients--frequent but mostly clinically insignificant. Eur J Clin Pharmacol. 2005 Oct;61(9):675-81. Epub 2005 Oct 19. — View Citation

Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol. 2008 Mar;65(3):303-16. Epub 2007 Dec 17. Review. — View Citation

Lau HS, Florax C, Porsius AJ, De Boer A. The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards. Br J Clin Pharmacol. 2000 Jun;49(6):597-603. — View Citation

Page RL 2nd, Ruscin JM. The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use. Am J Geriatr Pharmacother. 2006 Dec;4(4):297-305. — View Citation

Vira T, Colquhoun M, Etchells E. Reconcilable differences: correcting medication errors at hospital admission and discharge. Qual Saf Health Care. 2006 Apr;15(2):122-6. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Time to first unscheduled physician contact(general practitioner,emergency department, ambulatory care or re-admission to hospital) after discharge from the Orthopaedic Department		January 2010	No
Secondary	Admission time		October 2009	No