Multidisciplinary Program "Optimization of Drug Prescription" : Impact on the Quality of Drug Prescription in Hospitalized Elderly Patients (OPMED)

Civil Hospices of Lyon

Status: Completed

Conditions: Potentially Inappropriate Medications

Treatments: Other: " Optimisation de la Prescription MEDicamenteuse " ("Optimization of drug prescribing")

Study type: Observational

Funder types: Other

Identifiers

NCT01947270

D50789

Details and patient eligibility

About

Drug prescription is a fundamental component of care for the elderly. Even if drugs are a chance for the older patient, because of changes in pharmacological, pharmacokinetic and pharmacodynamic parameters related with age and acute/or chronic pathologies, the risks associated with drug prescription, particularly those associated with potentially inappropriate medication (PIM), are increased in the elderly.

We suppose that many of hospitalized elderly have at least one prescribed medication without valid indication. Conversely, many diseases are currently undertreated in elderly patients: e.g. medicines used to treat heart failure and osteoporosis are underused in 20 to 70% of patients. Moreover, PMI prescription is associated with an increased of morbidity, mortality, risk of drug-related adverse events, utilization of health care system, care costs and impairment of quality of life. Thus, optimization of drug prescription is a major concern for improvement of the quality and safety of care in elderly.

The investigators' hypothesis is that a multidisciplinary program entitled "Optimisation de la Prescription MEDicamenteuse" ("Optimization of drug prescribing") focused on drug prescription optimization including a physician training to the specificity of the drug prescription in the elderly and a checklist allowing an adapted and standardized pharmaceutical analysis is effective in reducing PIM in elderly patients hospitalized in short-term medical and geriatric care departments.

Enrollment: 3,055 patients

Sex: All

Ages: 75+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male or female subject aged over 75 years hospitalized in one of the participating department
• Patient agreed to participate

Exclusion criteria

• Patient with a predictive length of stay equal or less than 48 hours
• Patients admitted in terminal illness

Trial design

3,055 participants in 2 patient groups

Control group

Description:

Patients of this group are hospitalized in a time frame where the multidisciplinary intervention program is not implemented in the medical department. Drug prescriptions are conducted under usual care in the department.

Intervention group

Description:

Patients of this group are hospitalized in a time frame where the multidisciplinary intervention program is implemented in the medical department.

Treatment:

Other: " Optimisation de la Prescription MEDicamenteuse " ("Optimization of drug prescribing")