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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PIM-Check group | Experimental |
| |
| STOPP/START group | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PIM-Check | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of Potentially Inappropriate Prescriptions (PIPs) reduction in the PIM-Check group compared to STOPP/START | 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number and type of PIPs detected by each tool | 18 months | |
| Rate of acceptability | 18 months | |
| Number of treatment (mean and median) modification by clinicians |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Chantal Csajka, PharmD, PhD | Contact | +41 21 314 42 63 | chantal.csajka@chuv.ch | |
| Akram FARHAT, PharmD, MPH, PhD | Contact | akram.farhat@hotmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Universitaire Vaudois | Recruiting | Lausanne | Canton of Vaud | 1011 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36175740 | Derived | Farhat A, Al-Hajje A, Lang PO, Csajka C. Impact of Pharmaceutical Interventions with STOPP/START and PIM-Check in Older Hospitalized Patients: A Randomized Controlled Trial. Drugs Aging. 2022 Nov;39(11):899-910. doi: 10.1007/s40266-022-00974-7. Epub 2022 Sep 30. |
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| ID | Term |
|---|---|
| D000067561 | Potentially Inappropriate Medication List |
| ID | Term |
|---|---|
| D011785 | Quality Assurance, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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| STOPP/START | Other | 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. |
|
| 18 months |
| Number of drugs at discharge | 18 months |
| Incidence rate of falls | 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. | 18 months |
| Confusion Assessment Method (CAM) | Result ranges : [negative result (-) = no confusion] ; [positive result (+) = confusion]. | 18 months |
| Length of stay | 18 months |
| Number of unplanned readmission | up to 3 months after discharge |
| Association between the number and type of PIPs at discharge with rate of re-admission | up to 3 months after discharge |