This study's main objective is to investigate whether the application of an adapted person-centred prescription model during a hospital stay would reduce the use of inappropriate or futile regular medications in older people at the end of life, improving their clinical/health statuses and reducing the expense associated with pharmacological treatment. We hypothesised that applying this modified method could optimise pharmacotherapeutic indicators and the expense associated with the pharmacological treatment of hospitalised patients
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
114
Step 1: Identify patients with advanced chronic condition and limited life expectancy. Step 2: Interview with patients or closes caregiver. Step 3: Medication Review The clinical pharmacist conduct a structured medication review based on the medication appropriateness index (MAI): * Indication/effectiveness: Product information, STOPPFrail (Screening Tool of Older Persons' Prescriptions in Frail adults with limited life expectancy) criteria and Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. * Dosage adjustment: Product Information and Lexi-Comp's Geriatric Dosage Handbook. * Correct and practical directions: Medication Regimen Complexity Index (MRCI). * Drug-drug interactions: Bot Plus/Beers Criteria and drug burden index (DBI), which measures dose-dependent anticholinergic and sedative loads. * Drug-disease interactions: Beers Criteria. * Duplication, duration and cost-effectiveness: Product information. Step 4: Treatment Plan
Matia Foundation
Donostia / San Sebastian, Gipuzkoa, Spain
Change between admission and discharge in the number of regular medications.
Time frame: 3 months
Change between admission and discharge in the STOPP Frail Criteria
Time frame: 3 months
Change between admission and discharge in the Drug Burden Index (DBI)
Time frame: 3 months
Change between admission and discharge in the total drug-drug interactions
Time frame: 3 months
Change between admission and discharge in the Medication Regimen Complexity Index (MRCI)
Time frame: 3 months
Change in the 28-day cost of prescriptions in €
Time frame: 3 months
Number of patients who have had a new emergency department presentation.
Time frame: 3 months
Number of patients who have had unplanned hospital readmission
Time frame: 3 months
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