Geriatrics Clinical Trial
Official title:
Effectiveness of a Person-centred Prescription Model in Hospitalised Geriatric Patients at the End of Life
Verified date | July 2022 |
Source | Matia Foundation |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study's main objective is to investigate whether the application of an adapted person-centred prescription model during a hospital stay would reduce the use of inappropriate or futile regular medications in older people at the end of life, improving their clinical/health statuses and reducing the expense associated with pharmacological treatment. We hypothesised that applying this modified method could optimise pharmacotherapeutic indicators and the expense associated with the pharmacological treatment of hospitalised patients
Status | Completed |
Enrollment | 114 |
Est. completion date | February 28, 2021 |
Est. primary completion date | February 28, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 65 Years and older |
Eligibility | Inclusion Criteria: - Patients admitted to the geriatric convalescence unit and identified as having a non-oncological advanced chronic disease and being in need of palliative care, with a limited survival prognosis according to the necessity of palliative care (NECPAL) test. Exclusion Criteria: - Patients with hospital stays of less than 72 hours. - Patients transferred to other hospitals or units. - Patients with imminently terminal patients. |
Country | Name | City | State |
---|---|---|---|
Spain | Matia Foundation | Donostia | Gipuzkoa |
Lead Sponsor | Collaborator |
---|---|
Matia Foundation | Universidad de León, University of the Basque Country (UPV/EHU) |
Spain,
By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015 Nov;63(11):2227-46. doi: 10.1111/jgs.13702. Epub 2015 Oct 8. — View Citation
Espaulella-Panicot J, Molist-Brunet N, Sevilla-Sánchez D, González-Bueno J, Amblàs-Novellas J, Solà-Bonada N, Codina-Jané C. [Patient-centred prescription model to improve adequate prescription and therapeutic adherence in patients with multiple disorders]. Rev Esp Geriatr Gerontol. 2017 Sep - Oct;52(5):278-281. doi: 10.1016/j.regg.2017.03.002. Epub 2017 May 2. Spanish. — View Citation
George J, Phun YT, Bailey MJ, Kong DC, Stewart K. Development and validation of the medication regimen complexity index. Ann Pharmacother. 2004 Sep;38(9):1369-76. Epub 2004 Jul 20. — View Citation
Hanlon JT, Schmader KE, Samsa GP, Weinberger M, Uttech KM, Lewis IK, Cohen HJ, Feussner JR. A method for assessing drug therapy appropriateness. J Clin Epidemiol. 1992 Oct;45(10):1045-51. — View Citation
Hilmer SN, Mager DE, Simonsick EM, Cao Y, Ling SM, Windham BG, Harris TB, Hanlon JT, Rubin SM, Shorr RI, Bauer DC, Abernethy DR. A drug burden index to define the functional burden of medications in older people. Arch Intern Med. 2007 Apr 23;167(8):781-7. — View Citation
Lavan AH, Gallagher P, Parsons C, O'Mahony D. STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy): consensus validation. Age Ageing. 2017 Jul 1;46(4):600-607. doi: 10.1093/ageing/afx005. — View Citation
O'Mahony D, O'Connor MN. Pharmacotherapy at the end-of-life. Age Ageing. 2011 Jul;40(4):419-22. doi: 10.1093/ageing/afr059. Epub 2011 May 28. — View Citation
Potter K, Flicker L, Page A, Etherton-Beer C. Deprescribing in Frail Older People: A Randomised Controlled Trial. PLoS One. 2016 Mar 4;11(3):e0149984. doi: 10.1371/journal.pone.0149984. eCollection 2016. — View Citation
Thompson W, Lundby C, Graabaek T, Nielsen DS, Ryg J, Søndergaard J, Pottegård A. Tools for Deprescribing in Frail Older Persons and Those with Limited Life Expectancy: A Systematic Review. J Am Geriatr Soc. 2019 Jan;67(1):172-180. doi: 10.1111/jgs.15616. Epub 2018 Oct 13. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change between admission and discharge in the number of regular medications. | 3 months | ||
Secondary | Change between admission and discharge in the STOPP Frail Criteria | 3 months | ||
Secondary | Change between admission and discharge in the Drug Burden Index (DBI) | 3 months | ||
Secondary | Change between admission and discharge in the total drug-drug interactions | 3 months | ||
Secondary | Change between admission and discharge in the Medication Regimen Complexity Index (MRCI) | 3 months | ||
Secondary | Change in the 28-day cost of prescriptions in € | 3 months | ||
Secondary | Number of patients who have had a new emergency department presentation. | 3 months | ||
Secondary | Number of patients who have had unplanned hospital readmission | 3 months |
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