Combined Use of the Rationalization of Home Medication by an Adjusted STOPP in Older Patients (RASP) List and a Pharmacist-Led Medication Review in Very Old Inpatients: Impact on Quality of Prescribing and Clinical Outcome

摘要: Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. Our objective was to evaluate the effect of a intervention, consisting application Rationalization home medication an Adjusted STOPP Patients (RASP) list pharmacist-led review on polypharmacy, quality prescribing, clinical outcome geriatric inpatients. A monocentric, prospective controlled trial undertaken at wards large university hospital. Pharmacists applied RASP reconciled admission additionally performed expert-based review, upon recommendations were provided treating physicians. The primary composite endpoint drug discontinuation dose reduction taken admission. Secondary included RASP-identified medications (PIMs), number Emergency Department (ED) visits life (QOL) registered up 3 months after discharge. On average, patients (n = 172) took 10 84.5 years (standard deviation 4.8) age. More discontinued or intervention group {control vs. intervention: median (interquartile range [IQR]) 3 (2–5) 5 (3–7); p < 0.001}. PIMs group, leading less PIM discharge [control (IQR) 2 (1–3) 0.5 (0–1); p < 0.001]. No signal harm seen, significant improvement QOL ED without hospitalization observed. combined safely use very old inpatients outperformed usual care. An increased as well trend towards visits. ClinicalTrials.gov Identifier: NCT01513265.