NCT03640845: TEM-EHPAD

Impact of a Hospital Medication Expertise on Unplanned Hospitalizations at 3 Months of Nursing Homes Patients

Status unknown NA Last updated 27 July 2023

What this trial tests

NA trial testing tele-expertise in Age Problem in 364 participants. Status unknown.

Timeline

16 May 2019

Primary endpoint
16 March 2025

16 September 2025

Quick facts

Lead sponsor	Assistance Publique Hopitaux De Marseille
Phase	NA
Status	Status unknown
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	none
Primary purpose	other
Enrollment	364
Start date	16 May 2019
Primary completion	16 March 2025
Estimated completion	16 September 2025
Sites	1 location across France

Drugs / interventions tested

• tele-expertise

Conditions studied

• Age Problem — all drugs for Age Problem →

Sponsor

Assistance Publique Hopitaux De Marseille — full company profile →

Who can join

65 and older, any sex, with Age Problem. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

The use of drugs in the elderly population remains a major public health problem worldwide. Technological advances and the development of new drugs have helped to extend life expectancy. However, the complex process of aging, resulting in changes in physiological functions, may affect the pharmacodynamics and kinetics of medications taken by the elderly. In addition, polypharmacy, due to multiple comorbidities, may also lead to an increased risk of drug or field interaction and the use of potentially inappropriate drugs (PID), increasing the risk of drug iatrogenic use in older users.

With a view to optimizing drug prescriptions and preventing drug iatrogenic disease in the elderly, and in the context of a university-based research and teaching approach, the AP-HM pharmacy initiated the setting up of clinical pharmacy activities for patients at high iatrogenic risk.

The contribution of clinical pharmacists to mobile geriatric teams who carry out more than 2,200 geriatric assessments a year, is a way to optimize the efficiency of the medication management of the elderly person hospitalized out of hospital. geriatric service and EHPAD. TIn order to promote the physician-pharmacist action synergy observed in practice, the investigators decided to integrate the pharmaceutical evaluation with the geriatric evaluation. This new cooperation makes it possible to improve the knowledge of the treatments taken by the patients, to raise awareness on the observance of the treatments and to facilitate the administration of the drugs, to reduce the risks of iatrogenic medicinal increase the acceptance of therapeutic interventions by the health care team. Indeed, the first results show that the mobile team's medico-pharmaceutical interventions have a much higher acceptance rate than medical or pharmaceutical interventions alone.

However, the economic context and the human resources allocated do not make it possible to ensure an efficient service throughout the territory and in particular in nursing homes outside the city where the CHU is located. In order to increase the number of evaluations, the investigators propose to develop a tele-expertise of a medico-pharmaceutical hospital team (MPHT) and evaluate the impact for patients residing in nursing homes in the context of a high-level study.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

1. Interventions to improve the appropriate use of polypharmacy for older people.
   Cole JA, Gonçalves-Bradley DC, Alqahtani M, Barry HE, et al · · 2023 · cited 50× · PMID 37818791 · DOI 10.1002/14651858.cd008165.pub5
2. Impact of medication review via tele-expertise on unplanned hospitalizations at 3 months of nursing homes patients (TEM-EHPAD): study protocol for a randomized controlled trial.
   Correard F, Montaleytang M, Costa M, Astolfi M, et al · · 2020 · cited 6× · PMID 32312242 · DOI 10.1186/s12877-020-01546-3
3. Acceptability of a Novel Telemedication Review for Older Adults in Nursing Homes in France: A Qualitative Study.
   Costa M, Correard F, Montaleytang M, Baumstarck K, et al · · 2021 · cited 3× · PMID 33442242 · DOI 10.2147/cia.s283496