Does Systematic Medication Review in Elderly Patients Admitted to Orthopedic Departments Reduce Admission Time? - Full Text View

Purpose

Elderly patients has a higher risk of experiencing adverse drug events due to an age related increase in morbidity and medication use. Inappropriate or wrong medication use among elderly patients acutely admitted to hospitals is assumed to prolong patients inhospital stay if not corrected at admission to hospital. It is therefore our hypothesis that a systematic medication review conducted by pharmacists and physicians specialized in pharmacology will decrease elderly patients admission time in Orthopedic Departments from an average of five days to four days. Further, the following secondary outcome parameters will be measured at 3 and 12 month follow up:

time to first re-admission,
number of re-admissions,
number of death,
number of contact to primary health care
patients self-experienced quality of health (EQ-5D)

Condition	Intervention
Elderly	Other: Systematic medication review and advisory notes

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Prevention, Randomized, Open Label, Uncontrolled, Parallel Assignment, Safety Study

Official Title:	The Effect of Systematic Medication Review in Elderly Patients Admitted to an Orthopedic Department.

Further study details as provided by University of Aarhus:

Primary Outcome Measures:

Admission time for elderly patients >70 years admitted to an Orthopedic Department [ Time Frame: February 2009 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Time to first re-admission, Nb. of re-admission; death, Nb. of contacts to General practitioner;community nurses;emergency rooms, ambulatories;Finally patients self-experienced quality of life (EQ-5D questionnaire) [ Time Frame: 3 and 12 month after admission date ] [ Designated as safety issue: No ]

Estimated Enrollment:	100
Study Start Date:	September 2008
Estimated Study Completion Date:	October 2009
Estimated Primary Completion Date:	February 2009 (Final data collection date for primary outcome measure)

Arms

Assigned Interventions

Intervention

Systematic medication review

Other: Systematic medication review and advisory notes

Within 24 hours of admission a pharmacist retrieve medication histories from patients included in the intervention group. Medication histories will be obtained from - medical records, medication charts, patients electronical medication profile, interview with patients and if necessary contact to the patients general practitioner. The obtained medication history will be discussed with a physician specialized in pharmacology and an advisory note with suggested changes to the patients medication is added to the medical record. The orthopedic physicians are not obliged to follow the suggested changes

Eligibility

Ages Eligible for Study:	70 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

age > 70 years
expected admission time of more than 24 hours
acute admission

Exclusion Criteria:

Psychotic patients
Moribund patients
Suicidal patients

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00738816

Contacts


Contact: Marianne Lisby, MHSc	+45 61264949	lisby@as.aaa.dk

Locations


Denmark, Central Denmark Region
	Regional hospital, Randers	Not yet recruiting
	Randers, Central Denmark Region, Denmark, 8900
	Contact: Lars Peter Nielsen, MD +45 89421987 lpn@dadlnet.dk
	Principal Investigator: Marianne Lisby, MHSc

Sponsors and Collaborators

Aarhus University Hospital

More Information

Publications:

Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol. 2008 Mar;65(3):303-16. Epub 2007 Dec 17. Review.

Lau HS, Florax C, Porsius AJ, De Boer A. The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards. Br J Clin Pharmacol. 2000 Jun;49(6):597-603.

Glintborg B, Andersen SE, Dalhoff K. Drug-drug interactions among recently hospitalised patients--frequent but mostly clinically insignificant. Eur J Clin Pharmacol. 2005 Oct;61(9):675-81. Epub 2005 Oct 19.

Page RL 2nd, Ruscin JM. The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use. Am J Geriatr Pharmacother. 2006 Dec;4(4):297-305.

Vira T, Colquhoun M, Etchells E. Reconcilable differences: correcting medication errors at hospital admission and discharge. Qual Saf Health Care. 2006 Apr;15(2):122-6.

Responsible Party:	Aarhus University Hospital ( Marianne Lisby )
Study ID Numbers:	Klinfarm
First Received:	August 20, 2008
Last Updated:	August 20, 2008
ClinicalTrials.gov Identifier:	NCT00738816
Health Authority:	Denmark: Danish Dataprotection Agency; Denmark: The Danish National Committee on Biomedical Research Ethics

Keywords provided by University of Aarhus:

Medication review

Patient

Safety

Drug

Prescriptions

Drug-use

ClinicalTrials.gov processed this record on October 15, 2008

Sponsored by:	Aarhus University Hospital
Information provided by:	University of Aarhus
ClinicalTrials.gov Identifier:	NCT00738816