Less Is More: Optimized Pharmacotherapy With Improved coNtinuity of CarE in hospitaLized oLder peOple

Summary

The goal of this cluster randomized controlled trial is to compare transitional multidisciplinary pharmacotherapeutic care (TMPC) with usual care in patients aged 70 years or older with polypharmacy, admitted to the hospital via the emergency department for longer than 24 hours and that have an elevated risk of drug related readmissions.

The primary aims of the study are:

* To assess whether TMPC leads to a decrease in number of DRreAs compared to usual care during the first 30 days after index hospitalisation.
* To assess whether TMPC is cost-effective

Participants will receive TMPC in hospitals allocated to the intervention. TMPC will be executed by a pharmacotherapeutic team, it consists of the following four elements:

* pharmacotherapeutic analysis
* transitional multidisciplinary discussion
* pharmacotherapeutic care interview and discussion with the patient
* discharge note with the pharmacotherapeutic care plan

Researchers will compare TMPC with usual care to assess the effect and cost-effectiveness of TMPC.

Conditions

• Polypharmacy
• Medication Review

Interventions

OTHER

Transitional Multidisciplinary Pharmacotherapeutic Care

A structured medication review with improved transitional care and multidisciplinary collaboration. TMPC consists of the following four elements: 1. A structured pharmacotherapeutic analysis 2. A transitional multidisciplinary discussion.The treating physician in the hospital will be involved. The general practitioner and community pharmacist will be consulted. 3. An interview and discussion with the patient and/or legal representative by a member of the Pharmacotherapy-team, which will be performed before the patient is discharged from the hospital. 4. A discharge note with the pharmacotherapeutic care plan. This will be sent to the community pharmacist and the general practitioner.

Sponsors & Collaborators

• Amsterdam UMC, location VUmc

  collaborator OTHER

• Amsterdam UMC, location AMC

  collaborator OTHER

• Amphia ziekenhuis

  collaborator UNKNOWN

• Catharina Ziekenhuis Eindhoven

  collaborator OTHER

• Deventer Ziekenhuis

  collaborator OTHER

• Diakonessenhuis, Utrecht

  collaborator OTHER

• Erasmus Medical Center

  collaborator OTHER

• HagaZiekenhuis

  collaborator OTHER

• Leiden University Medical Center

  collaborator OTHER

• Meander Medisch Centrum

  collaborator OTHER

• University Medical Center Groningen

  collaborator OTHER

• UMC Utrecht

  collaborator OTHER

• Zaans Medisch Centrum

  collaborator OTHER

• Ziekenhuisgroep Twente

  collaborator OTHER

• ZonMw: The Netherlands Organisation for Health Research and Development

  collaborator OTHER

• Zorgevaluatie Nederland

  collaborator UNKNOWN

• Canisius Wilhelmina Ziekenhuis (CWZ)

  collaborator UNKNOWN

• Radboud University Medical Center

  lead OTHER

Principal Investigators

• Kees Kramers, Prof. Dr. · Radboud University Medical Center

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-06-05

Primary Completion

2025-04-01

Completion

2026-01-17

Countries

• Netherlands

Study Locations