A Collaborative Approach to Medication Reviews for Older Patients With Polypharmacy (BIMEDOC)

Toulouse University Hospital

Status

Completed

Conditions

Medication Therapy Management

Treatments

Other: Medication therapy management

Study type

Interventional

Funder types

Other

Identifiers

NCT03909035

RC31/17/0454

2018/A00213/52 (Other Identifier)

17-0277 (Other Grant/Funding Number)

Details and patient eligibility

About

In patients aged 65 years and older, polypathology is frequent and often associated with polypharmacy. This polypharmacy may be a source of iatrogeny due to pharmacokinetic interactions, enhanced sensitivity of older people to medication, or failure to adhere to the therapy. Since January 2018, French community pharmacists have been allowed by the Health ministry to perform medication reviews for people aged 65 years and over, who are being treated with more than 5 medications a day. the present hypothesis is that medication therapy management performed in collaboration with patients, general practitioners, and community pharmacists will lead to a reduction in medical events and inappropriate prescriptions.

Full description

This is a stepped-wedge cluster randomised controlled trial conducted in 9 regions of France. Each region represents one cluster with 7 community pharmacies located around the University Hospital associated with that cluster. In total, 63 community pharmacies will be enrolled, with each pharmacy including 20 patients over a 10 month-period. Over the life-time of the project, a total of 1260 patients will benefit from either the intervention or from a controlled pharmaceutical care according to the period of time they will be enrolled.

Enrollment

697 patients

Sex

All

Ages

65+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patient aged 65 or older suffering from long-term illness
Patient aged 75 or older
Living at home
Having 5 medications or more per day for more than 6 months
Being a regular patient of the community pharmacy involved in the study
General practitioner of the patient agrees to participate to the study
Patient being mentally and physically able to decide on his own to participate in the study
Patient available by phone throughout the study

Exclusion criteria

Patient refuses to participate
Patient without a family doctor
Patient whose family doctor refuses to participate in the study
Patient who does not understand French, or dependant on someone else to manage his medication
Resident of a nursing home
Patient placed under guardianship
Uncertainty of the pharmacist about patient reliability
Patient having benefited from a medication review in the previous 12 months
Patient already included in another study