Lorenz Van der Linden|Liesbeth Decoutere|Karolien Walgraeve|Koen Milisen|Johan Flamaing|Isabel Spriet|Jos Tournoy
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
KU Leuven|Jessa Hospital|KU Leuven|KU Leuven|KU Leuven|KU Leuven|KU Leuven
polypharmacy potentially inappropriate drugs associated negative outcomes older adults might reduced pharmacist interventions objective evaluate effect pharmacist intervention consisting application rationalization home medication adjusted stopp older patients rasp list pharmacistled medication review polypharmacy quality prescribing clinical outcome geriatric inpatients monocentric prospective controlled trial undertaken geriatric wards large university hospital pharmacists applied rasp list drugs reconciled admission additionally performed expertbased medication review upon recommendations provided treating physicians primary outcome composite endpoint drug discontinuation dose reduction drugs taken admission secondary outcomes included raspidentified potentially inappropriate medications pims number emergency department ed visits quality life qol registered 3 months discharge average patients n 172 took 10 drugs admission 845 years standard deviation 48 age drugs discontinued reduced dose intervention group control vs intervention median interquartile range iqr 3 25 vs 5 37 p 0001 pims discontinued intervention group leading less pim discharge control vs intervention median iqr 2 13 vs 05 01 p 0001 signal harm seen significant improvement qol less ed visits without hospitalization observed combined intervention safely reduced drug use old inpatients outperformed usual geriatric care increased qol seen well trend towards less ed visits clinicaltrialsgov identifier nct01513265