Impact of Medications Review on Potentially Inappropriate Medications and Clinical Outcomes Among Hospitalized Older Adults

M

Monash University

Status

Enrolling

Conditions

Polypharmacy
Potentially Inappropriate Medications
Inappropriate Prescribing
Aged
Deprescriptions

Treatments

Other: MALPIP criteria

Study type

Interventional

Funder types

Other

Identifiers

NCT05875623
REVMED RCT

Details and patient eligibility

About

The goal of this randomized controlled trial is to assess the effectiveness of a pharmacist-led medication review using the locally developed Malaysian Potentially Inappropriate Prescribing Screening tool in Older Adults (MALPIP), an explicit criteria in hospitalized older adults. The main questions it aims to answer are: The effectiveness of the intervention in reducing the number of PIMs and chronic medications after discharge The impact of the intervention on quality of life, falls events, emergency department visits, readmissions and survivals Researchers will compare the control group to see if there is corresponding changes to the outcomes specified above.

Enrollment

500 estimated patients

Sex

All

Ages

60+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Patients aged 60 years and above
  • Taking more than five regular drugs
  • Having at least one chronic medical condition
  • Ability to understand and speak Malay, English, or Mandarin language

Exclusion criteria

  • Admitted for end-of-life care
  • Diagnosed with terminal illness
  • Diagnosed with active cancer
  • Participated in another drug trial
  • Refused or unable to give consent
  • Visited the Emergency Department without admission to ward
  • Readmitted and have been previously enrolled in the trial

Trial design

500 participants in 2 patient groups

Intervention
Experimental group
Description:
In the intervention group, the clinical pharmacist will apply the MALPIP criteria on all the admission and discharge medications. The pharmacists can access the full MALPIP list at https://sites.google.com/moh.gov.my/malpip/home. The intervention will consist of 4 steps: i) pharmacist review using MALPIP criteria to detect PIM, ii) discussion with doctors for deprescribing decision iii) discussion with patients and documentation of shared decision iv) follow up patients at 6, 12, and 18 months. Pharmacists will perform the reviewing and checking by themselves and discuss the suggestions with doctors during daily medical ward rounds. The attending doctors will decide whether to deprescribe based-on pharmacists suggestions. Then, the pharmacists will discuss the deprescribing proposal with the patients and record the decision.
Treatment:
Other: MALPIP criteria
Control
No Intervention group
Description:
In the control arm, pharmacists, patients and doctors are not purposefully blinded but are not aware of the intervention (i.e. the MALPIP tool). Designated pharmacist at the control sites identifies patients who match the eligibility requirements and enroll them into the trial after obtaining consent. Patients in the control arm will receive routine care and support that they entitled to from the medical team and clinical pharmacists. Preadmission medication will be reconciled by a clinical pharmacist using the standard procedures, including medication history assessment form (CP1), pharmacotherapy review (CP2) and the clinical pharmacy report form (CP3).

Trial contacts and locations

0

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Central trial contact

Shaun Lee, PhD; Chee Tao Chang, Msc

Data sourced from clinicaltrials.gov

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