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Polypharmacy is a common problem in elderly, leading among others to increased adverse drug events. The aim of this pilot study was to evaluate whether a systematic medication evaluation by a geriatric consultation team using the RASP (Rationalisation of drugs on admission by an adjusted STOPP*-list in older patients) list could reduce inappropriate prescribing for elderly admitted patients, admitted to non-geriatric departments.
(* = Screening Tool of Older Persons' potentially inappropriate Prescriptions)
Polypharmacy and (potentially) inappropriate prescribing is highly prevalent in the older population, associated with increase health care expenditures, morbidity and avoidable adverse events .
The aim of this pilot study was to evaluate whether a systematic medication evaluation by a geriatric consultation team (GCT) using the RASP (Rationalisation of drugs on admission by an adjusted STOPP-list in older patients) list could reduce inappropriate prescribing for older admitted patients, admitted to non-geriatric departments. The GCT could offer the ideal format to deliver the intervention to a broad older hospitalised population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GCT | No Intervention | In a before phase, data on how the GCT operated (i.e. good clinical practice) was gathered. | |
| GCT-RASP | Active Comparator | Medication review, based on but not limited to the RASP list |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Medication review, based on but not limited to the RASP list | Other | Systematic approach:
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of medication-related recommendations by the geriatric consultation team. | The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of potentially inappropriate drugs at discharge, as identified by the RASP list. | The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days. | |
| Number of drugs at discharge, relative to the drugs on admission. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lorenz R Van der Linden, PharmD | Universitaire Ziekenhuizen KU Leuven | Principal Investigator |
| Johan Flamaing, MD, PhD | Universitaire Ziekenhuizen KU Leuven | Principal Investigator |
| Jos Tournoy, MD, PhD | Universitaire Ziekenhuizen KU Leuven | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospitals Leuven | Leuven | Flemish Brabant | 3000 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29970005 | Derived | Van der Linden L, Hias J, Dreessen L, Milisen K, Flamaing J, Spriet I, Tournoy J. Medication review versus usual care to improve drug therapies in older inpatients not admitted to geriatric wards: a quasi-experimental study (RASP-IGCT). BMC Geriatr. 2018 Jul 3;18(1):155. doi: 10.1186/s12877-018-0843-y. |
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| ID | Term |
|---|---|
| D007049 | Iatrogenic Disease |
| D000073496 | Frailty |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000090143 | Medication Review |
| ID | Term |
|---|---|
| D008509 | Medication Systems |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
| D010346 | Patient Care Management |
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|
| The number was ascertained at time of discharge from the ward, taking into account an average hospital stay of 14 days. |
| Acceptance rate of the GCT interventions by the treating physician. | Up to 72 hours after the GCT had given its recommendations. |