Optimising Therapy to prevent avoidable hospital admissions in the multimorbid elderly

Rationale

Rationale & Aim

Drug-related morbidity and mortality is an increasing problem in European healthcare systems. Multimorbidity, polypharmacy and old age are important risk factors for drug-related hospital admissions (DRA). [1] The reported incidence of DRAs in the elderly may be as high as 30% of all acute cases, [1,3] and about half of DRAs are likely to be preventable. [1,4] They are mainly related to prescribing problems and non-compliance with drug regimens. A significant proportion of healthcare costs are spent on unnecessary interventions and inappropriate medications.

The aim of the OPERAM trial is to assess whether pharmacotherapy optimisation leads to reduced drug related hospital admissions. 

References

  1. Leendertse AJ, Egberts AC, Stoker LJ, van den Bemt PM. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch Intern Med 2008;168:1890-6.
  2. Gillespie U, Alassaad A, Henrohn D, et al. A comprehensive pharmacist intervention to reduce morbidity in patients 80 years or older: a randomized controlled trial. Arch Intern Med 2009;169:894-900.
  3. Howard RL, Avery AJ, Slavenburg S, et al. Which drugs cause preventable admissions to hospital? A systematic review. Br J Clin Pharmacol 2007;63:136-47.
  4. Pirmohamed M, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ. 2004;329:15-19.