Impact of a Mobile Geriatric Team With a Pharmacist on the Optimisation of Prescriptions in Elderly Inpatients

Medication Therapy Management Clinical Trial

— PHARMOG  

Official title:

Impact of a Mobile Geriatric Team With a Pharmacist on the Optimisation of Prescriptions in Elderly Inpatients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04151797
• Other study ID #: RC31/17/0353
• Status: Completed
• Phase: N/A
• Start date: November 19, 2019
• Est. completion date: March 22, 2021

Study information

• Verified date: May 2021
• Source: University Hospital, Toulouse
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

In patients aged 75 years and older, polypathology is frequent and often associated with polypharmacy. This polypharmacy coupled with a lack of proactive elderly care can sometimes lead to hospitalisation. Due to comorbidities and complex problems, management of geriatric patients usually requires a multidisciplinary approach. In Toulouse University Hospital, elderly inpatients can benefit from a geriatric assessment by a Geriatric Mobile Team. Whether this team improve the prescriptions through the advice of a clinical pharmacist has not been demonstrated yet.

Description:

All participants will be identified via the geriatrician of the mobile geriatric team with the following inclusion criteria: age ≥ 75 years, ≥ 5 medications per day and being hospitalised either in emergency room, short-stay medicine unit or in a surgery department. For each patient, the pharmacist will detect potentially inappropriate prescribing (based on explicit criteria and an implicit approach) and liaise with the geriatrician for drug optimisations. The pharmaceutical advice will be added to the geriatrician's written report, and then addressed to the relevant physician. The implementation of the proposals will be evaluated immediately at the end of hospitalisation, and then reassessed three months later by calling the patient and/or his community pharmacist. A total of 250 patients will be enrolled over a 12 month-period. The evolution of potentially inappropriate prescribing will be assessed and their cost evaluated.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 200
• Est. completion date: March 22, 2021
• Est. primary completion date: March 22, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 75 Years and older

Eligibility

Inclusion Criteria:

• Patient aged 75 or older
• Having 5 medications or more per day
• Being hospitalised either in emergency room, short-stay medicine unit or surgery department

Exclusion Criteria:

• Patient refuses to participate
• Patient already included in another study

Related Conditions & MeSH terms

• Medication Therapy Management

Intervention

Other:
• Medication therapy management
The intervention is in the form of a pharmacist-led medication review aimed at detecting potentially inappropriate prescribing. It includes: Data collection on comorbidities, medication and laboratory results. A pharmacist's evaluation of the prescriptions based on the patient's conditions and on the current recommendations for clinical practice. A detailed feedback to the geriatrician. A written report addressed to the attending physician

Locations

Country	Name	City	State
France	Toulouse University Hospital	Toulouse	Occitanie

Sponsors (2)

Lead Sponsor	Collaborator
University Hospital, Toulouse	Institut National de la Santé Et de la Recherche Médicale, France

Country where clinical trial is conducted

France, 

References & Publications (1)

Pagès A, Roland C, Qassemi S, Abdeljalil AB, Houles M, Romain M, Toulza O, Belloc A, McCambridge C, Voisin T, Cestac P, Juillard-Condat B; PharMoG study group. Impact of a Pharmacist-included Mobile Geriatrics team intervention on potentially inappropriate drug prescribing: protocol for a prospective feasibility study (PharMoG study). BMJ Open. 2020 Dec 2;10(12):e040917. doi: 10.1136/bmjopen-2020-040917. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change from baseline patients' number of potentially inappropriate prescription at the patient discharge after optimization by a mobile geriatric team with pharmacist	number of potentially inappropriate prescribing per patient before (month 0) and after the intervention of the mobile geriatric team (at the patient discharge)	Month 0 and max Month 2 (At the patient discharge)
Secondary	Change from baseline patients' number of potentially inappropriate prescription at 3 months after optimization by a mobile geriatric team with pharmacist	number of potentially inappropriate prescribing per patient before (month 0) and after the intervention of the mobile geriatric team (month 3)	Month 0, Month 3
Secondary	Change from baseline patients' number with at least one potentially inappropriate drug at 3 months after optimization by a mobile geriatric team with pharmacist	number of patients with at least one potentially inappropriate drug before (month 0) and after the intervention of the mobile geriatric team (month 3)	Month 0, Month 3
Secondary	Change from baseline ratio of potentially inappropriate drug per patient at 3 months after optimization by a mobile geriatric team with pharmacist	ratio of potentially inappropriate drug per patient before (month 0) and after (month 3) the intervention of the mobile geriatric team.	Month 0, Month 3
Secondary	Change from baseline mean number of medications per patient at 3 months	Mean number of medications per patient	Month 0, Month 3
Secondary	realisation of a pharmacist-led medication review in primary care	Number of pharmacist-led medication review performed in primary care at 3 months	Month 3
Secondary	number of falls 3 months after pharmacist-led medication review	Number of falls	Month 3
Secondary	mortality 3 months after pharmacist-led medication review	Number of deaths	Month 3
Secondary	re-hospitalisation, including emergency room transfers	Number of non-scheduled hospitalisations (including emergency department transfers)	Month 3
Secondary	The nursing home transfers	Number of nursing home transfers	Month 3