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. 2023 Jan 23;2023(1):CD008986. doi: 10.1002/14651858.CD008986.pub4

NCT03827031.

Study name Impact of multidisciplinary medication assessment review in surgery departments (CHIROPMEV)
Methods Randomised controlled trial
Participants Setting: surgery departments
Inclusion criteria:

  • The patient (or their representative) has given his consent and signed the consent form

  • The patient is affiliated to a health insurance programme

  • The patient is at least 65 years old (≥) treated by at least (≥) 5 medications for at least (≥) 6 months

  • The patient is available for a follow‐up of 3 months

  • The patient is hospitalised in the surgery department

  • Patient with a Trivalle score greater than or equal to 2 (≥)

  • Patient living in a nursing home or going back home after hospitalisation


Exclusion criteria:

  • The patient is participating in another category I interventional study

  • The patient is in an exclusion period determined by another study

  • The patient is under safeguard of justice

  • It is not possible to give the patient (or his/her trusted‐person) informed information

  • Palliative care
Interventions There are 3 study arms: intervention 1 (multidisciplinary medication review), intervention 2 (multidisciplinary medication review with community pharmacist follow‐up) and control
The multidisciplinary medication review entails medication reconciliation and pharmaceutical analysis by a clinical pharmacist, and a physician performs a clinical examination and analysis of the medical record. Both participate in a collaborative interview. The hospital physician calls the community pharmacist to discuss proposed changes on the order and to establish a new prescription. At the end of the stay, the clinical pharmacist will conduct an exit interview with the patient. For participants in intervention group 2, a summary of the follow‐up report stating the therapeutic modifications will be sent to the community pharmacist and physician.
Outcomes Primary outcome:

  • Change in iatrogenic drug risk in intervention groups versus control group (time frame: 3 months after hospitalisation)


Secondary outcomes:

  • Proportion of proposed medication modifications made by the clinical pharmacist accepted by the clinical doctor during the multidisciplinary medication review in the experimental groups (time frame: hospital discharge (maximum 30 days))

  • Number of potentially inappropriate medications per patient in each group (time frame: hospital discharge (maximum 30 days))

  • Proportion of proposed medication modifications made by the collaborative team accepted and/or made permanent (time frame: 3 months after hospital discharge)

  • Number of potentially inappropriate medications per patient in each group (time frame: 3 months after hospital discharge)

  • Time required for multidisciplinary medication review in the interventional groups (B1 and B2) (time frame: hospital discharge (maximum 30 days))

  • Time required for transmitting multidisciplinary correspondence documents in B2 group (time frame: hospital discharge (maximum 30 days))

  • Number of multidisciplinary correspondence documents sent to the community actors in B2 group (time frame: hospital discharge (maximum 30 days))

  • Description of mode of diffusion of multidisciplinary correspondence documents in the B2 group (time frame: hospital discharge (maximum 30 days))

  • Description of reason for non‐transmission of multidisciplinary correspondence documents in the B2 group (time frame: hospital discharge (maximum 30 days))

  • Rate of patients for whom a follow‐up review of proposed medication changes has been performed by the pharmacist in the B2 group (time frame: 2 months post‐discharge)

  • Number of multidisciplinary correspondence documents transmitted by community pharmacist in group B2 (time frame: 2 months post hospital discharge)

  • Rate of patients with at least one rehospitalisation in each group (time frame: 3 months after hospital discharge)

  • Mortality rate in each group (time frame: 3 months after hospital discharge)

  • Healthcare team satisfaction in interventional groups (B1, B2) (time frame: 3 months after hospital discharge)
Starting date Estimated study start date: June 2022
Contact information Jean‐Marie Kinowski. Email: jean.marie.kinowski@chu-nimes.fr
Notes Trial ID: NCT03827031