Impact of Medication Reconciliation at Discharge on Potentially Inappropriate Medications in the Elderly : Community-hospital Coordination

Geriatric Clinical Trial

— ICM2SA  

Official title:

Impact of Medication Reconciliation at Discharge on Potentially Inappropriate Medications in the Elderly : Community-hospital Coordination. ICM2SA

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03415113
• Other study ID #: PI2016_843_0003
• Status: Completed
• Phase: N/A
• First received: December 27, 2017
• Last updated: January 23, 2018
• Start date: April 14, 2016
• Est. completion date: September 30, 2016

Study information

• Verified date: January 2018
• Source: Centre Hospitalier Universitaire, Amiens
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The geriatric population is exposed to poly-medication. Furthermore, old people have important pharmacodynamic and pharmacokinetic changes that expose to much drug iatrogenic. Adverse drug effects are a great cause for hospitalization that is why the knowledge of the complete list of medications taken by the patient is necessary. The poly-medication in elderly can lead to extremely serious clinical consequences and significant costs. Reference documents specific to geriatrics guide the doctor in therapeutic choices. On the one hand, the Laroche's criteria lists all PIM of the French pharmacopoeia in elderly. On the other hand, STOPP/START criteria are a tool for detect PIM listing inappropriate drugs and criteria of potentially drug omissions. This has been validated in French language. It is important that any changes proposed by the geriatrician resulting in just prescription is sustainable beyond the hospitalization to prevent the recurrence of adverse effects. Effective community-hospital coordination is essential.

Medication reconciliation is defined as the formal process of checking the complete, accurate list of a patient's previous medication — including drug name, dosage, frequency, and route — and comparing it with the prescription after a transition of care (on admission, after transfer to another medical unit, and/or at discharge).

Two groups of patients will be created, one for which medication reconciliation at discharge will be practiced and the other a similar process but not standardized. Four to eight weeks after the discharge, the member of the pharmacy team is calling the usual community pharmacy to get the first non-hospital prescription by fax and compare the number of PIM with the prescription before hospitalization.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 60
• Est. completion date: September 30, 2016
• Est. primary completion date: September 30, 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 75 Years and older

Eligibility

Inclusion Criteria:

• Male or female, age = 75 years

• Pharmaceutical interview at the medication reconciliation at admission in Geriatrics Acute Care Unit.

• = one PIM on the prescription before admission

• Identification of the usual referent community pharmacist

• Output of the unit by a return home

• Affiliation to a social security scheme

Exclusion Criteria:

• Patients undergoing a regime of legal protection.

• Patients unable to cooperate in pharmaceutical interview at the medication reconciliation at admission whatever reason.

• Refusal to participate in the study.

• Output of the unit by transfering to another care unit or death

Related Conditions & MeSH terms

• Geriatric
• Hospital

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Centre Hospitalier Universitaire, Amiens

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Quantification of potentially inappropriate medication prescription	Quantification of potentially inappropriate medication on the first non-hospital	4 or 8 weeks