Impact of Multidisciplinary Review of Drug Prescriptions on Patient Safety in a Residence for Dependent Elderly

Overview

The main objective of the study is to show that the multidisciplinary review of drug prescriptions changes the adverse drug event (ADE) geriatric risk score (according to Trivalle and Ducimetière 2013) for patients living in the Nîmes University Hospital Residence for Dependent Elderly.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Prevention
    • Masking: None (Open Label)
  • Study Primary Completion Date: February 2015

Detailed Description

The secondary objectives of this study are to assess and compare the following criteria before and after multidisciplinary review of drug prescriptions for patients in the Nîmes University Hospital Residence for Dependent Elderly: A. the number of patients with at least one potentially inappropriate drug prescribed B. the number of hospitalizations C. death rate D. the number of falls per patient and the rate of fallers E. qualitative criteria describing the drug review F. associated care costs

Interventions

  • Other: Before-after study
    • The before-after study is composed of a first observational phase followed by a proactive phase, and then finally by a second observational phase. The first observational phase corresponds to retrospective data-collecting for the information necessary for calculating the baseline ADE geriatric risk score. The proactive phase corresponds to a multidisciplinary review of drug prescriptions (especially long-term drugs) for all included patients in the residence. During the second observational phase, the same data as in the first observational phase will be collected a second time.

Arms, Groups and Cohorts

  • Other: The study population
    • See inclusion and exclusion criteria. Intervention: Before-after study

Clinical Trial Outcome Measures

Primary Measures

  • Adverse Drug Events Geriatric Risk Score
    • Time Frame: change from Baseline to 6 months
    • according to Trivalle and Ducimetière 2013

Secondary Measures

  • The number of patients taking at least 1 potentially inappropriate drug according to Laroche criteria
    • Time Frame: During the proactive phase. Day 0.
    • Laroche et al 2007.
  • Number of hospitalizations in the public sector (higher level care)
    • Time Frame: first observational phase (month -6 to day 0)
  • Number of hospitalizations in the public sector (higher level care)
    • Time Frame: second observational phase (day 0 to month 6)
  • Days of hospitalization in the public sector (higher level care)
    • Time Frame: first observational phase (month -6 to day 0)
  • Days of hospitalization in the public sector (higher level care)
    • Time Frame: second observational phase (day 0 to month 6)
  • Mortality
    • Time Frame: first observational phase (month -6 to day 0)
  • Mortality
    • Time Frame: second observational phase (day 0 to month 6)
  • The number of falls per patient
    • Time Frame: first observational phase (month -6 to day 0)
  • The number of falls per patient
    • Time Frame: second observational phase (day 0 to month 6)
  • The percentage of patients who fell
    • Time Frame: first observational phase (month -6 to day 0)
  • The percentage of patients who fell
    • Time Frame: second observational phase (day 0 to month 6)
  • The Anatomical Therapeutic Chemical classification for each revised drug
    • Time Frame: during the proactive phase (day 0)
  • The type of errors detected during drug review
    • Time Frame: during the proactive phase (day 0)
    • Contra-indication, dosing, route, etc
  • The type of modification suggested during drug review
    • Time Frame: during the proactive phase (day 0)
    • discontinuation, addition, substitution…
  • The acceptation rate for modifications suggested during drug review
    • Time Frame: during the proactive phase (day 0)
  • Associated care costs (€)
    • Time Frame: first observational phase (month -6 to day 0)
  • Associated care costs (€)
    • Time Frame: second observational phase (day 0 to month 6)

Participating in This Clinical Trial

Inclusion Criteria

  • The patient (or his/her legal representative) must have given his/her informed and signed consent – The patient must be insured or beneficiary of a health insurance plan – The patient is available for 6 months of follow-up – The patient has resided at the Nîmes University Hospital Residence for Dependent Elderly for at least the past 6 months Exclusion Criteria:

  • The patient is participating in another study – The patient is in an exclusion period determined by a previous study – The patient is under judicial protection – The patient (or his/her legal representative) refuses to sign the consent – It is impossible to correctly inform the patient (or his/her legal representative) – The patient has resided at the Nîmes University Hospital Residence for Dependent Elderly for less than 6 months

Gender Eligibility: All

Minimum Age: 65 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Centre Hospitalier Universitaire de Nīmes
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Géraldine Leguelinel, Pharm-D, Study Director, Centre Hospitalier Universitaire de Nîmes

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