| Project/Area Number |
18K15434
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 52010:General internal medicine-related
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| Research Institution | St. Marianna University School of Medicine |
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Principal Investigator |
Kenya Ie 聖マリアンナ医科大学, 医学部, 准教授 (20608939)
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| Project Period (FY) |
2018-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
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| Keywords | ポリファーマシー / 処方適正化 / ランダム化比較試験 / 老年医学 / 潜在的不適切処方 / 高齢者 / 減薬プロトコル |
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| Outline of Final Research Achievements |
This was a single-center, open-label, randomized controlled trial. Patients aged 65 years or older who were admitted to a community hospital internal medicine department and were on five or more regular medications were randomly assigned to an intervention group based on a deprescribing protocol or a usual care. 1) primary endpoint: composite of re-hospitalization, unplanned hospital visit, or all-cause death (2) Secondary endpoints: deaths during hospitalization, injuries due to falls, after-hours visits, health-related quality of life, level of care required, number of medications, number of potentially inappropriate prescriptions, human and time costs of the intervention, and (3) adverse events were compared between the two groups. A total of 460 participants participated in the study, and after 12 months of follow-up, data collection and statistical analysis is currently undertaken. The results will be presented at a conference and published in a peer-reviewed journal.
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| Academic Significance and Societal Importance of the Research Achievements |
本邦でも2016年より薬剤総合評価調整加算による減薬への政策誘導が始まっており、減薬が労力・コストに見合う有効性があるのか検証することが社会的に求められている。臨床試験でポリファーマシー介入の真の有効性を証明することができれば、介入の臨床応用を促進する世界的にも価値の高い研究成果となることが見込まれる。本研究では、多職種チームによるSTOPP/STARTクライテリアと処方適正化プロトコルを相補的に活用した介入により高齢入院患者の死亡、再入院、予定外受診へ及ぼす効果を単施設並行群間比較試験により検証することを目指している。
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