Informations générales (source: ClinicalTrials.gov)
Optimization of Drug Prescribing in an Elderly Population of Geriatric Consultations and Living at Home (OPTIM)
Interventional
N/A
Hospices Civils de Lyon (Voir sur ClinicalTrials)
mai 2016
novembre 2020
29 juin 2024
Aging is often associated with multiple chronic conditions conducting increased
consumption of drugs. Drug therapy is necessary for the treatment of many diseases.
However, misuse of drugs, particularly linked to the potentially inappropriate
prescribing and polypharmacy, increases the iatrogenic risks and can lead to adverse
events such as falls, cognitive decline, increased use to the health system: hospital
admissions, emergency room visits, and institutionalization. These problems are common
since about 20% of emergency room use in elderly patients due to an adverse event related
to drugs. Nearly 28% of adverse events related to drug prescriptions could be avoided.
Interventions to optimize drug therapy showed a reduction in the number of potentially
inappropriate medications, but their impact on health, has rarely been evaluated. If an
association with death has been established, the link with the loss of functional
autonomy, which leads to reduced quality of life and significant cost of care, has not
been investigated. The evolution towards functional disabilities, frequent with aging has
many causes, among which some could be prevented. The optimization of drug prescriptions
could thereby delay or prevent the loss of functional autonomy by reducing the risk of
adverse events, such as falls or cognitive decline and improving the management of
chronic diseases. Our hypothesis is that an optimization program of the drug prescribing
may slow progression to functional dependence. To assess the effect of the optimization
program of drug prescribing on the level of functional autonomy, a multicenter Randomized
Controlled Trial will be conducted in geriatric and memory consultations.
Expected results The implementation of the "OPTIM" program should enable optimization of
drug prescribing in elderly patients and therefore slow or prevent progression to
addiction. It should also help to develop and strengthen collaboration and communication
between the team of geriatric consultation, the clinician pharmacist and referring
physicians in town (private practice). In addition, pharmaceutical notice sent to
referring physicians should help raise awareness of the prescription of drugs in these
patients.
Etablissements
| Les établissements hors Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| Hôpital des Charpennes - Lyon - France | Pierre Krolak Salmon, PU PH | Contact (sur clinicalTrials) | |||
| Hôpital gériatrique du Mont d'Or - Albigny sur Saône - France | Aurélia MARFISI - DUBOST, PH | Contact (sur clinicalTrials) | |||
Critères
Tous
Inclusion Criteria:
- Patients aged 65 and over;
- Patients received for the first time in a geriatric or memory consultation of a
study recruiting centers;
- Patients living at home;
- Patients with the ability to express themselves orally or in writing in French
sufficiently to carry out clinical assessments;
- Patients who led the last drugs prescription from his referring physician, at the
geriatric/memory consultation (in current practice, patients should take the last
prescription established by the referring physician);
- Patients accompanied by a caregiver.
- Patients aged 65 and over;
- Patients received for the first time in a geriatric or memory consultation of a
study recruiting centers;
- Patients living at home;
- Patients with the ability to express themselves orally or in writing in French
sufficiently to carry out clinical assessments;
- Patients who led the last drugs prescription from his referring physician, at the
geriatric/memory consultation (in current practice, patients should take the last
prescription established by the referring physician);
- Patients accompanied by a caregiver.
- Patients with no discernment;
- Patient put under legal protection;