OBJECTIVES: to evaluate specialist geriatric input and medication review in patients in high-dependency continuing care. DESIGN: prospective, randomised, controlled trial. SETTING: two residential continuing care hospitals. PARTICIPANTS: two hundred and twenty-five permanent patients. INTERVENTION: patients were randomised to either specialist geriatric input or regular input. The specialist group had a medical assessment by a geriatrician and medication review by a multidisciplinary expert panel. Regular input consisted of review as required by a medical officer attached to each ward. Reassessment occurred after 6 months. RESULTS:one hundred and ten patients were randomised to specialist input and 115 to regular input. These were comparable for age, gender, dependency levels and cognition. After 6 months, the total number of medications per patient per day fell from 11.64 to 11.09 in the specialist group (P = 0.0364) and increased from 11.07 to 11.5 in the regular group (P = 0.094). There was no significant difference in mortality or frequency of acute hospital transfers (11 versus 6 in the specialist versus regular group, P = 0.213). CONCLUSION: specialist geriatric assessment and medication review in hospital continuing care resulted in a reduction in medication use, but at a significant cost. No benefits in hard clinical outcomes were demonstrated. However, qualitative benefits and lower costs may become evident over longer periods.
RCT Entities:
OBJECTIVES: to evaluate specialist geriatric input and medication review in patients in high-dependency continuing care. DESIGN: prospective, randomised, controlled trial. SETTING: two residential continuing care hospitals. PARTICIPANTS: two hundred and twenty-five permanent patients. INTERVENTION: patients were randomised to either specialist geriatric input or regular input. The specialist group had a medical assessment by a geriatrician and medication review by a multidisciplinary expert panel. Regular input consisted of review as required by a medical officer attached to each ward. Reassessment occurred after 6 months. RESULTS: one hundred and ten patients were randomised to specialist input and 115 to regular input. These were comparable for age, gender, dependency levels and cognition. After 6 months, the total number of medications per patient per day fell from 11.64 to 11.09 in the specialist group (P = 0.0364) and increased from 11.07 to 11.5 in the regular group (P = 0.094). There was no significant difference in mortality or frequency of acute hospital transfers (11 versus 6 in the specialist versus regular group, P = 0.213). CONCLUSION: specialist geriatric assessment and medication review in hospital continuing care resulted in a reduction in medication use, but at a significant cost. No benefits in hard clinical outcomes were demonstrated. However, qualitative benefits and lower costs may become evident over longer periods.
Authors: Tim Johansson; Muna E Abuzahra; Sophie Keller; Eva Mann; Barbara Faller; Christina Sommerauer; Jennifer Höck; Christin Löffler; Anna Köchling; Jochen Schuler; Maria Flamm; Andreas Sönnichsen Journal: Br J Clin Pharmacol Date: 2016-05-07 Impact factor: 4.335
Authors: Jean-Baptiste Beuscart; Lisa G Pont; Stefanie Thevelin; Benoit Boland; Olivia Dalleur; Anne W S Rutjes; Johanna I Westbrook; Anne Spinewine Journal: Br J Clin Pharmacol Date: 2017-01-18 Impact factor: 4.335
Authors: Victor Johan Bernard Huiskes; Cornelia Helena Maria van den Ende; Martine Kruijtbosch; Hendrik Tinus Ensing; Marieke Meijs; Veronique Maria Mathea Meijs; David Marinus Burger; Bartholomeus Johannes Fredericus van den Bemt Journal: Br J Clin Pharmacol Date: 2019-12-03 Impact factor: 4.335
Authors: Carlota Mestres Gonzalvo; Hugo A J M de Wit; Brigit P C van Oijen; Kim P G M Hurkens; Rob Janknegt; Jos M G A Schols; Wubbo J Mulder; Frans R Verhey; Bjorn Winkens; Paul-Hugo M van der Kuy Journal: BMC Geriatr Date: 2017-01-26 Impact factor: 3.921
Authors: Victor Johan Bernard Huiskes; David Marinus Burger; Cornelia Helena Maria van den Ende; Bartholomeus Johannes Fredericus van den Bemt Journal: BMC Fam Pract Date: 2017-01-17 Impact factor: 2.497