Rationalisation of Polypharmacy in the Elderly by the RASP Instrument

Universitaire Ziekenhuizen KU Leuven

Status: Completed

Conditions: Healthy

Treatments: Other: Pharmaceutical care plan, mostly based on the RASP

Study type: Interventional

Funder types: Other

Identifiers

NCT01513265

S-53664

Details and patient eligibility

About

The aim of this study is to determine whether a clinical pharmacist using the RASP list (RASP = Rationalisation of home medication by an adjusted STOPP-list in older patients; STOPP = Screening Tool of Older Persons' potentially inappropriate Prescriptions) can optimise the drug use in elderly inpatients.

Full description

Older persons take on average multiple drugs. As people age, there is an apparent increase in pharmacodynamic sensitivity to different making the patient more prone to experience side effects. Alterations in body composition and concomitant changes in pharmacokinetic parameters can also result in a higher risk for adverse drug events. All these factors make the older person, notwithstanding the heterogeneity of this population, more vulnerable for the negative consequences of polypharmacy.

Polypharmacy is a cause of negative clinical outcomes but it still remains unclear which intervention or set of interventions should be used to optimize the prescription of pharmacotherapy in the elderly patient. Therefore, the investigators developed the RASP (RASP = Rationalisation of home medication by an adjusted STOPP-list in older patients; STOPP = Screening Tool of Older Persons' potentially inappropriate Prescriptions), a list as tool to reduce polypharmacy adapted to Belgian national prescribing tendencies within geriatric wards. Content and reliability of the RASP have been validated and the investigators aim to further study the impact of the systematic implementation of this RASP on geriatric wards in a prospective cluster randomized controlled trial.

Enrollment: 172 patients

Sex: All

Ages: 65+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Signed informed consent by the patient or a caregiver if the patient is incompetent to sign
• Consecutive inclusion of all newly admitted patients to the wards coming from home or the emergency room department

Exclusion criteria

• Patients not admitted to the hospital from home or a nursing home
• Patients unable to communicate in Dutch
• Patients admitted for palliative care
• Patients who do not take any drugs at admission

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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172 participants in 2 patient groups

RASP

Active Comparator group

Treatment:

Other: Pharmaceutical care plan, mostly based on the RASP

Control group

No Intervention group

Description:

Subjects enrolled in this arm will undergo usual medical and pharmaceutical care with registration of drug use at admission and discharge without interference of RASP or clinical pharmacist.