Impact of a Mobile Geriatric Team With a Pharmacist on the Optimisation of Prescriptions in Elderly Inpatients (PHARMOG)

In patients aged 75 years and older, polypathology is frequent and often associated with polypharmacy. This polypharmacy coupled with a lack of proactive elderly care can sometimes lead to hospitalisation. Due to comorbidities and complex problems, management of geriatric patients usually requires a multidisciplinary approach. In Toulouse University Hospital, elderly inpatients can benefit from a geriatric assessment by a Geriatric Mobile Team. Whether this team improve the prescriptions through the advice of a clinical pharmacist has not been demonstrated yet.

Study Overview

• Status: Completed
• Conditions: Medication Therapy Management
• Intervention / Treatment: Other: Medication therapy management

Detailed Description

All participants will be identified via the geriatrician of the mobile geriatric team with the following inclusion criteria: age ≥ 75 years, ≥ 5 medications per day and being hospitalised either in emergency room, short-stay medicine unit or in a surgery department. For each patient, the pharmacist will detect potentially inappropriate prescribing (based on explicit criteria and an implicit approach) and liaise with the geriatrician for drug optimisations. The pharmaceutical advice will be added to the geriatrician's written report, and then addressed to the relevant physician. The implementation of the proposals will be evaluated immediately at the end of hospitalisation, and then reassessed three months later by calling the patient and/or his community pharmacist. A total of 250 patients will be enrolled over a 12 month-period. The evolution of potentially inappropriate prescribing will be assessed and their cost evaluated.

• Study Type: Interventional
• Enrollment (Actual): 200
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Occitanie
    • Toulouse, Occitanie, France, 31059
      • Toulouse University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 75 years and older (Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patient aged 75 or older
• Having 5 medications or more per day
• Being hospitalised either in emergency room, short-stay medicine unit or surgery department

Exclusion Criteria:

• Patient refuses to participate
• Patient already included in another study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Medication therapy management; Medication therapy management by pharmacist-led medication review

Other: Medication therapy management; The intervention is in the form of a pharmacist-led medication review aimed at detecting potentially inappropriate prescribing. It includes: Data collection on comorbidities, medication and laboratory results.; A pharmacist's evaluation of the prescriptions based on the patient's conditions and on the current recommendations for clinical practice.; A detailed feedback to the geriatrician.; A written report addressed to the attending physician

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline patients' number of potentially inappropriate prescription at the patient discharge after optimization by a mobile geriatric team with pharmacist	number of potentially inappropriate prescribing per patient before (month 0) and after the intervention of the mobile geriatric team (at the patient discharge)	Month 0 and max Month 2 (At the patient discharge)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline patients' number of potentially inappropriate prescription at 3 months after optimization by a mobile geriatric team with pharmacist	number of potentially inappropriate prescribing per patient before (month 0) and after the intervention of the mobile geriatric team (month 3)	Month 0, Month 3
Change from baseline patients' number with at least one potentially inappropriate drug at 3 months after optimization by a mobile geriatric team with pharmacist	number of patients with at least one potentially inappropriate drug before (month 0) and after the intervention of the mobile geriatric team (month 3)	Month 0, Month 3
Change from baseline ratio of potentially inappropriate drug per patient at 3 months after optimization by a mobile geriatric team with pharmacist	ratio of potentially inappropriate drug per patient before (month 0) and after (month 3) the intervention of the mobile geriatric team.	Month 0, Month 3
Change from baseline mean number of medications per patient at 3 months	Mean number of medications per patient	Month 0, Month 3
realisation of a pharmacist-led medication review in primary care	Number of pharmacist-led medication review performed in primary care at 3 months	Month 3
number of falls 3 months after pharmacist-led medication review	Number of falls	Month 3
mortality 3 months after pharmacist-led medication review	Number of deaths	Month 3
re-hospitalisation, including emergency room transfers	Number of non-scheduled hospitalisations (including emergency department transfers)	Month 3
The nursing home transfers	Number of nursing home transfers	Month 3

Collaborators and Investigators

• Sponsor: University Hospital, Toulouse
• Collaborators: Institut National de la Santé Et de la Recherche Médicale, France
• Investigators: Principal Investigator: Philippe CESTAC, PharmD, PhD, University Hospital, Toulouse

Publications and helpful links

General Publications

• Pages A, Roland C, Qassemi S, Abdeljalil AB, Houles M, Romain M, Toulza O, Belloc A, McCambridge C, Voisin T, Cestac P, Juillard-Condat B; PharMoG study group. Impact of a Pharmacist-included Mobile Geriatrics team intervention on potentially inappropriate drug prescribing: protocol for a prospective feasibility study (PharMoG study). BMJ Open. 2020 Dec 2;10(12):e040917. doi: 10.1136/bmjopen-2020-040917.

Study record dates

Study Major Dates

• Study Start (Actual): November 19, 2019
• Primary Completion (Actual): March 22, 2021
• Study Completion (Actual): March 22, 2021

Study Registration Dates

• First Submitted: October 15, 2019
• First Submitted That Met QC Criteria: November 4, 2019
• First Posted (Actual): November 5, 2019

Study Record Updates

• Last Update Posted (Actual): November 28, 2025
• Last Update Submitted That Met QC Criteria: November 21, 2025
• Last Verified: May 1, 2021

More Information

Terms related to this study

• Keywords: polypharmacy; Medication review; older people; inappropriate prescribing; clinical pharmacy; collaboration
• Additional Relevant MeSH Terms: Health Services Administration; Health Services; Health Care Facilities Workforce and Services; Health Care Economics and Organizations; Patient Care Management; Financing, Organized; Economics; Pharmaceutical Services; Medicare Part D; Insurance, Pharmaceutical Services; Insurance, Health; Insurance; Medicare; Medication Therapy Management
• Other Study ID Numbers: RC31/17/0353

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No