Home Improvement Initiative of the TRaitement Optimisé Medicamenteux After Hospitalization (IATRO'MED)

University Hospital, Strasbourg, France

Status: Terminated

Conditions: Chronic Disease; Surgery; Clinical Pharmacy; Older Adult; Ambulatory Care

Treatments: Behavioral: EOPC Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT04020692

7363

Details and patient eligibility

About

The hypothesis is that the intervention of an operational clinical pharmacy team (EOPC), targeting both patients and hospital and health care professionals, allows: i) to initiate a therapeutic review during hospitalization, ii) to accompany the patients upon hospital discharge, iii) to maintain, in outpatient care, the drug treatments that have been optimized during hospitalization.

The main objective of the study is to demonstrate that the intervention of an EOPC in surgical departments and then in outpatient care makes it possible to maintain, 45 days after the discharge of the patients aged 65 years and over, the chronic outpatient treatments revised and optimized during the hospital stay.

The secondary objectives are to measure the impacts of EOPC's intervention on:

• unexpected readmissions, emergency use, medical complications and adverse drug reactions;
• patient and health professional satisfactions (community pharmacists and physicians);
• the costs of drug treatments in ambulatory care.

Enrollment: 223 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient (man or woman)
• age ≥ 65 years with more than 3 drugs taken for 3 months, stay in surgery with a duration of ≥ 1 days including urgent surgery;
• affiliated to a social health insurance scheme;
• for whom a return home is possible;
• able to understand the objectives of the research and give informed, dated and signed consent.

Exclusion criteria

• Patient (man or woman)
• with as a hospital discharge an entry into a nursing home or long-term care called "important medical and technical care (SMTI);
• with cognitive or other problems preventing consent (at the discretion of the geriatric expertise team);
• under the safeguard of justice;
• under tutorship or curatorship.

Trial design

Primary purpose: Supportive Care

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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223 participants in 2 patient groups

"intervention " group

Experimental group

Description:

Patient At D0, the patient receives his discharge drugs prescription and benefits from a pharmaceutical counselling. At D+3, he benefits from a telephone follow-up (good understanding of the methods of taking drugs, collection of difficulties). Community pharmacist At D0, he receives the discharge drugs prescription. At D+3, he is contacted to collect information relating to drugs 'dispensation. The attending physician At D0, he is informed of the patient's discharge and his drugs treatment At D45, the data collection is based on telephone interviews \[attending physician, pharmacist and patient (and if applicable the caregiver)\]. It makes possible to collect drugs taken by the patient as well as significant events over the period (acute pathologies, re-hospitalizations, etc.).

Treatment:

Behavioral: EOPC Intervention

Control group

No Intervention group

Description:

At D0, the patient receives his discharge drugs prescription. At D45, the data collection is based on telephone interviews \[attending physician, pharmacist and patient (and if applicable the caregiver)\]. It makes possible to collect drugs taken by the patient as well as significant events over the period (acute pathologies, re-hospitalizations, etc.).