NCT02918058: MedSafer

Reducing Post-discharge Potentially Inappropriate Medications Among Older Adults

Completed NA Last updated 17 April 2018

What this trial tests

NA trial testing MedSafer in Polypharmacy in 924 participants. Completed in 15 June 2017.

Timeline

1 September 2016

Primary endpoint
15 May 2017

15 June 2017

Quick facts

Lead sponsor	McGill University Health Centre/Research Institute of the McGill University Health Centre
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	non randomized
Design	parallel
Masking	double
Primary purpose	prevention
Enrollment	924
Start date	1 September 2016
Primary completion	15 May 2017
Estimated completion	15 June 2017
Sites	1 location across Canada

Drugs / interventions tested

• MedSafer

Conditions studied

• Polypharmacy — all drugs for Polypharmacy →
• Deprescription — all drugs for Deprescription →
• Aged — all drugs for Aged →

Sponsor

McGill University Health Centre/Research Institute of the McGill University Health Centre

Who can join

Adults 65 to 120, any sex, with Polypharmacy or Deprescription. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Potentially inappropriate medications (PIMs) can lead to adverse drug events (ADEs) among older adults and especially those classified as frail. ADEs are responsible for nearly 27,000 hospital admissions in Canada annually. Within 30 days of discharge, medications contribute to two-thirds of adverse events, with nearly 60% being preventable or ameliorable. MedSafer is software product that guides patients and physicians in the community through the process of deprescribing. MedSafer electronically cross-references patient comorbidities with the most recent evidence-based PIMs, as of the study date, in order to generate a patient-tailored deprescribing care plan. This study will evaluate whether this application, when applied at hospitalization, leads to a reduction in the proprotion of patients with PIMs prescribed at discharge, by highlighting harmful medications for deprescription to treating physicians. This study will take place on the clinical teaching units (CTUs) at four hospitals. Based on historical records, the investigators estimate enrolling 480 patients aged 65 or older over three months. A trained research assistant will identify eligible patients, and will enter their medications, comorbidities, and an estimate of frailty into MedSafer. A deprescribing plan will be generated for the CTU team containing rationale for suggested medication changes and strategies for safe and successful deprescription. The CTU team will then decide in conjunction with the patient or proxy, and with relevant consultants, which medications can rationally be stopped or tapered at discharge.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. The MedSafer Study: A Controlled Trial of an Electronic Decision Support Tool for Deprescribing in Acute Care.
   McDonald EG, Wu PE, Rashidi B, Forster AJ, et al · · 2019 · cited 51× · PMID 31250427 · DOI 10.1111/jgs.16040