UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000027189
Receipt number R000031157
Scientific Title Impact of hospitalization due to medical illness on inappropriate prescribing in elderly patients: a prospective observational study.
Date of disclosure of the study information 2017/04/29
Last modified on 2020/02/01 23:41:11

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Basic information

Public title

Impact of hospitalization due to medical illness on inappropriate prescribing in elderly patients: a prospective observational study.

Acronym

Impact of hospitalization on inappropriate prescribing in elderly patients

Scientific Title

Impact of hospitalization due to medical illness on inappropriate prescribing in elderly patients: a prospective observational study.

Scientific Title:Acronym

Impact of hospitalization on inappropriate prescribing in elderly patients

Region

Japan


Condition

Condition

Geriatrics

Classification by specialty

Geriatrics

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

To evaluate the effect of hospitalizations for medical illness on potentially inappropriate medications in elderly patients from admission to discharge. The other is to investigate the association between PIMs and unplanned readmission.

Basic objectives2

Others

Basic objectives -Others

To investigate the association between PIMs and unplanned readmission.

Trial characteristics_1


Trial characteristics_2


Developmental phase



Assessment

Primary outcomes

The temporal change in the proportion of patients taking any PIMs from admission to discharge.

Key secondary outcomes

The association between PIMs at discharge and unplanned readmission (30-day and 90-day).


Base

Study type

Observational


Study design

Basic design


Randomization


Randomization unit


Blinding


Control


Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms


Purpose of intervention


Type of intervention


Interventions/Control_1


Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

65 years-old <=

Age-upper limit

110 years-old >=

Gender

Male and Female

Key inclusion criteria

Patients aged 65 years or older admitted to the internal medicine ward

Key exclusion criteria

1) A second admission to a medical ward during the study period
2) Death during the hospitalization
3) Transfer to other hospitals or other wards in our hospital
4) Hospitalization for diagnostic testing only
5) Missing data

Target sample size

650


Research contact person

Name of lead principal investigator

1st name Junpei
Middle name
Last name Komagamine

Organization

National Hospital Organization Tochigi Medical Center

Division name

Internal medicine

Zip code

3208580

Address

1-10-37, Nakatomatsuri, Utsunomiya, Tochigi, Japan

TEL

028-622-5241

Email

jkomagamine@tochigi-mc.jp


Public contact

Name of contact person

1st name Junpei
Middle name
Last name Komagamine

Organization

National Hospital Organization Tochigi Medical Center

Division name

Internal medicine

Zip code

320-8580

Address

1-10-37, Nakatomatsuri, Utsunomiya, Tochigi, Japan

TEL

028-622-5241

Homepage URL


Email

jkomagamine@tochigi-mc.jp


Sponsor or person

Institute

National Hospital Organization Tochigi Medical Center

Institute

Department

Personal name



Funding Source

Organization

None

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

National Hospital Organization Tochigi Medical Center

Address

1-10-37, Nakatomatsuri, Utsunomiya, Tochigi 320-8580, Japan

Tel

028-622-5241

Email

web-info@tochigi-mc.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2017 Year 04 Month 29 Day


Related information

URL releasing protocol

https://bmjopen.bmj.com/content/9/11/e032574.info

Publication of results

Published


Result

URL related to results and publications

https://bmjopen.bmj.com/content/9/11/e032574.info

Number of participants that the trial has enrolled

739

Results

The proportions of patients taking any PIMs at admission and discharge were 47.2% and 32.2%, respectively. Of all the patients, 39 (5.3%) were readmitted within 30 days after discharge for the index hospitalisation. The use of PIMs at discharge was not associated with an increased risk of 30-day readmission (OR 0.93; 95% CI 0.46 to 1.87). This result did not change after adjusting for patient age, sex, number of medications, duration of hospital stay and comorbidities (OR 0.78; 95% CI 0.36 to 1.66).

Results date posted

2020 Year 02 Month 01 Day

Results Delayed


Results Delay Reason


Date of the first journal publication of results

2019 Year 11 Month 07 Day

Baseline Characteristics

Seven hundred thirty-nine patients were included in this study. The median patient age was 82 years (IQR 74-88); 389 (52.6%) were women, and the median Charlson Comorbidity Index was 2 (IQR 0-3).

Participant flow

Of all the patients, 39 (5.3%) were readmitted within 30 days after discharge for the index hospitalisation.

Adverse events

Of all the patients, 39 (5.3%) were readmitted within 30 days after discharge for the index hospitalisation.

Outcome measures

The primary outcome was 30-day unplanned readmissions. The secondary outcome was the prevalence of any PIM use at admission and discharge. PIMs were defined based on the Beers Criteria.

Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Main results already published

Date of protocol fixation

2017 Year 04 Month 29 Day

Date of IRB

2017 Year 05 Month 01 Day

Anticipated trial start date

2017 Year 05 Month 01 Day

Last follow-up date

2018 Year 11 Month 30 Day

Date of closure to data entry


Date trial data considered complete


Date analysis concluded



Other

Other related information

Study design:
Prospective observational study
Setting/Participants:
Community general hospital (1 site) with inpatient care.
To evaluate the effect of hospitalizations for medical illness on inappropriate prescribing in elderly patients, 130 consecutive hospitalized patients aged 65 or older who survive to discharge will be included.
To evaluate the association between PIMs at discharge and 30-day unplanned readmission, approximately 550 consecutive hospitalized patients aged 65 or older who survive to discharge will be included.
Measures:
Review of medical records in Tochigi Medical Center. The primary outcome is the change in the proportion of patients taking any PIMs from admission to discharge. PIMs will be defined based on 2015 AGS Beers criteria. The secondary outcome is the association between PIMs at discharge and unplanned readmission (30-day and 90-day). Fisher's exact test will be used to compare the proportion of patients taking any PIMs between admission and discharge. Logistic regression analysis for binary responses using odds ratios will be employed to evaluate the association between PIMs at discharge and 30-day unplanned readmission.


Management information

Registered date

2017 Year 04 Month 29 Day

Last modified on

2020 Year 02 Month 01 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031157


Research Plan
Registered date File name
2017/04/29 PIM hispitalization prospective cohort study protocol 20170422.docx

Research case data specifications
Registered date File name

Research case data
Registered date File name