Optimizing Drug-Therapy in Patients 80 Years and Older

Drug-Related Problems Clinical Trial

Official title:

Optimizing Drug-Therapy in Patients, 80 Years and Older, in Order to Reduce Drug-Related Morbidity and Usage of Secondary Care - a Randomized Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00661310
• Other study ID #: Uppsala80
• Status: Completed
• Phase: N/A
• First received: April 14, 2008
• Last updated: December 4, 2008
• Start date: September 2005
• Est. completion date: June 2007

Study information

• Verified date: October 2008
• Source: Uppsala University Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: Sweden: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to measure the effects of an enhanced service where a pharmacists is part of the healthcare team on the ward (focusing on drug-related problems and transferring information between primary and secondary care). Primary outcome measure is visits to hospital during a 12-month follow-up period, and the population is patients 80 years and older.

Description:

Optimising drug-therapy for patients, 80 years and older, to reduce hospital visits

Background and Objective:

Results from a pilot-study performed in 2004 at the Academic Hospital, Uppsala, including 214 consecutive patients (80 years old or older) showed that 9.4%-13.6% of the patients were acutely admitted to hospital due to a drug related problem1. Other similar international studies show that the frequency of drug-related hospital admissions stands for at least 14% of the acute admissions (14%-30.4%). Of these admissions it was estimated that 32%-69% were preventable 2,3,4.

A study from Antrim Hospital, Northern Ireland, showed that pharmacists´ involvement in the health care team can reduce the number of acute hospital admissions and improve quality of drug use5.

In view of these findings this study was initiated in 2005 with fundings from the Drug and Therapeutics committee, the County Council of Uppsala, the Division of Acute-Medicine and the Pharmacy Department at the Academic Hospital in Uppsala

Aim and objectives:

The Study Aim was to optimize drug-prescribing and drug use for patients 80 years and older.

The main objective was to reduce the number of hospital visits for patients 80-years old or older.

Design:

A randomized, controlled trial including 400 patients (200+200). Patients in the intervention group (I) received a patient interview on admission, drug counseling on discharge and a drug review - all performed by a clinical pharmacist. Patients in the control group (C) received standard care, without pharmacists´ involvement.

Patients were included between Oct 2005 and June 2006.

Setting:

Two wards at the Division of Acute-Medicine at Uppsala University Hospital, Sweden

Main Outcome Measures:

1) Frequency of hospital visits 12 months after (last included patient) discharge from hospital for (I) and (C).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 400
• Est. completion date: June 2007
• Est. primary completion date: June 2006
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 80 Years and older

Eligibility

Inclusion Criteria:

• 80 years and older

• Acute admission to study ward

Exclusion Criteria:

• <80 years

• Scheduled admission

• Previously admitted to studyward during study period

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research

Related Conditions & MeSH terms

• Drug-Related Problems

Intervention

Other:
• Drug review 80+ -To reduce usage of hospital care
drug review performed by multiprofessional team, including clinical pharmacist, in order to optimize drug therapy and reduce usage of hospital care. Also patient education and follow-up

Locations

Country	Name	City	State
Sweden	Uppsala University hospital	Uppsala

Sponsors (2)

Lead Sponsor	Collaborator
Uppsala University Hospital	Uppsala University

Country where clinical trial is conducted

Sweden, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Effects on hospital visits		1 year	Yes