A mono-center, randomized controlled trial will be conducted at the University Hospital of Lausanne. Hospitalized patients will be randomly assigned from the emergency department to two sub-units composing the acute care for elders (ACE) unit. In one subunit, potentially inappropriate prescriptions will be detected and treatment optimized according PIM-Check. In the other, STOPP/START criteria will be independently applied.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
464
In the PIM-Check group, a medication review will be conducted using PIM-Check within 72 hours of patient's admittance to the unit. The physician will decide whether to accept these recommendations or not and implement prescribing changes if agreed.
In the STOPP/START group, medication lists will be analyzed within 72 hours of patient's admittance and optimized according to STOPP/START criteria. The second physician will decide whether to accept these recommendations or not and implement prescribing changes if agreed.
Centre Hospitalier Universitaire Vaudois
Lausanne, Canton of Vaud, Switzerland
RECRUITINGRate of Potentially Inappropriate Prescriptions (PIPs) reduction in the PIM-Check group compared to STOPP/START
Time frame: 18 months
Number and type of PIPs detected by each tool
Time frame: 18 months
Rate of acceptability
Time frame: 18 months
Number of treatment (mean and median) modification by clinicians
Time frame: 18 months
Number of drugs at discharge
Time frame: 18 months
Incidence rate of falls
Time frame: 18 months
Activities of daily living (ADL) score
Activities of daily living are routine activities people do every day without assistance (6 basic activities) : eating, bathing, getting dressed, toileting, transferring, and continence. The score is the number of activities performed without assistance. Score ranges : from 0/6 (minimum) to 6/6 (maximum). Higher values represent a better outcome of activities of daily living.
Time frame: 18 months
Confusion Assessment Method (CAM)
Result ranges : \[negative result (-) = no confusion\] ; \[positive result (+) = confusion\].
Time frame: 18 months
Length of stay
Time frame: 18 months
Number of unplanned readmission
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Time frame: up to 3 months after discharge
Association between the number and type of PIPs at discharge with rate of re-admission
Time frame: up to 3 months after discharge