Effect of Systematic Medication Review in Elderly Patients Admitted to an Orthopedic Department - Full Text View

Purpose

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

Condition	Intervention
Elderly	Other: Systematic medication review and advisory notes

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Prevention
Official Title:	The Effect of Systematic Medication Review in Elderly Patients Admitted to an Orthopedic Department.

Further study details as provided by University of Aarhus:

Primary Outcome Measures:

Time to first unscheduled physician contact(general practitioner,emergency department, ambulatory care or re-admission to hospital) after discharge from the Orthopaedic Department [ Time Frame: January 2010 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Admission time [ Time Frame: October 2009 ] [ Designated as safety issue: No ]

Enrollment:	108
Study Start Date:	April 2009
Study Completion Date:	April 2010
Primary Completion Date:	February 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Intervention Systematic medication review	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

Arms

Assigned Interventions

Intervention

Systematic medication review

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

Eligibility

Ages Eligible for Study:	65 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

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

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00738816

Locations

Denmark
Regional hospital, Randers
Randers, Central Denmark Region, Denmark, 8900

Sponsors and Collaborators

Aarhus University Hospital

Investigators

Principal Investigator:

Nielsen Lars Peter, Assoc. Prof.

Aarhus University Hospital, Denmark

More Information

Publications:

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.

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.

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.

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.

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.

Responsible Party:	Marianne Lisby, Aarhus University Hospital
ClinicalTrials.gov Identifier:	NCT00738816 History of Changes
Other Study ID Numbers:	Klinfarm
Study First Received:	August 20, 2008
Last Updated:	December 13, 2010
Health Authority:	Denmark: Danish Dataprotection Agency Denmark: The Danish National Committee on Biomedical Research Ethics

Keywords provided by University of Aarhus:

Medication review
Patient
Safety

Drug
Prescriptions
Drug-use

ClinicalTrials.gov processed this record on May 16, 2013