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Randomized Controlled Trial
. 2017 Aug;73(8):937-947.
doi: 10.1007/s00228-017-2263-x. Epub 2017 May 26.

Patterns of drug prescriptions in an orthogeriatric ward as compared to orthopaedic ward: results from the Trondheim Hip Fracture Trial-a randomised clinical trial

Marianne Heltne  1   2 , Ingvild Saltvedt  3   4 , Stian Lydersen  5 , Anders Prestmo  2   6 , Olav Sletvold  2   6 , Olav Spigset  7   8
Affiliations
Randomized Controlled Trial

Patterns of drug prescriptions in an orthogeriatric ward as compared to orthopaedic ward: results from the Trondheim Hip Fracture Trial-a randomised clinical trial

Marianne Heltne et al. Eur J Clin Pharmacol. 2017 Aug.

Abstract

Purpose: In the Trondheim Hip Fracture Trial, 397 home-dwelling patients with hip fractures were randomised to comprehensive geriatric care (CGC) in a geriatric ward or traditional orthopaedic care (OC). Patients in the CGC group had significantly better mobility and function 4 months after discharge. This study explores group differences in drug prescribing and possible associations with the outcomes in the main study.

Methods: Drugs prescribed at admission and discharge were registered from hospital records. Mobility, function, fear of falling and quality of life were assessed using specific rating scales. Linear regression was used to analyse association between drug changes and outcomes at 4 months.

Results: The mean age was 83 years, and 74% were females. The mean number (± SD) of drugs in the CGC and OC groups was 3.8 (2.8) and 3.9 (2.8) at inclusion and 7.1 (2.8) and 6.2 (3.0) at discharge, respectively (p = 0.003). The total number of withdrawals was 209 and 82 in the CGC and OC groups, respectively (p < 0.0001), and the number of starts was 844 and 526, respectively (p < 0.0001). A significant negative association was found between the number of drug changes during the hospital stay and mobility and function 4 months later in both groups. However, this association disappeared when adjusting for baseline function and comorbidities.

Conclusion: These secondary analyses suggest that there are significant differences in the pharmacological treatment between geriatric and orthopaedic wards, but these differences could not explain the beneficial effect of CGC in the Trondheim Hip Fracture Trial.

Keywords: Comprehensive geriatric care; Frail elderly; Geriatric assessment; Hip fracture; Pharmacotherapy; Polypharmacy.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflicts of interests.

Figures

Fig. 1
Fig. 1
Patient flow. Patients admitted to the hospital with hip fractures were screened in the emergency department and randomised after giving their informed consent. CGC comprehensive geriatric care, OC orthopaedic care
See this image and copyright information in PMC

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