Preventing adverse drug reactions after discharge: protocol for a randomised controlled trial in older people

Introduction. Adverse drug reactions (ADRs) in older people are common following hospital discharge. Effective interventions are required to combat the burden of ADRs. The Prediction of Hospitalisation due to Adverse Drug Reactions in Elderly Community Dwelling Patients (PADR-EC) score is a validated risk score developed to assess the risk of ADRs in people aged 65 years and older and can be utilised as part of an intervention to reduce ADRs.

Aims. To investigate the effectiveness of an intervention to reduce ADR incidence in older people after hospitalisation.

Methods. An open-label randomised controlled trial is being conducted at the public 500-bed Royal Hobart Hospital, Tasmania, Australia. Following admission, the PADR-EC score for ADR risk will be calculated, communicated to hospital clinicians and discussed with patients. Following discharge, nominated general practitioners and community pharmacists will receive the risk score and bespoke pharmacist-developed interpretation of the score to guide ongoing patient care. ADRs will be identified through hospital readmissions along with patient and general practitioner contact to 12 months post-discharge. The primary outcome is the incidence rate of moderate-severe ADRs that requires hospital treatment, change in therapy or specific treatment at 12 months post-discharge.

Discussion. It is hypothesised that the trial will reduce ADRs in the intervention population.