CHARMER WP4 Definitive Trial
Research type
Research Study
Full title
CompreHensive GeriAtRician led MEdication Review (CHARMER) - Work Package 4 Definitive Trial
IRAS ID
323504
Contact name
David Wright
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
2 years, 5 months, 28 days
Research summary
As we get older, our bodies are less able to handle some medicines. Medicines that were once effective and safe may not have as much benefit and may have an increased chance of causing harm. Research shows that almost half of older people in hospital are prescribed a medication with a risk of harm, but these medicines are rarely stopped.
In our previous research we asked older people and their carers about their thoughts on stopping these medicines. They told us that they would like these medicines reviewed by doctors in hospital during their stay and for those no longer needed or that could cause harm to be stopped. This is called ‘proactive deprescribing’ and is different to stopping a medicine after harm has occurred.
To make this happen we need to change doctor and pharmacist behaviour so that the idea of stopping medicines is more likely to be discussed with patients.
The CHARMER (CompreHensive geriAtRician led MEdication Review) Programme is funded by the NIHR and will develop and test a way to support geriatricians (doctors working on older people’s medicine wards) and hospital pharmacists to proactively deprescribe for older people whilst they are in hospital.
We have explored the reasons why geriatricians and hospital pharmacists do not proactively deprescribe for older people, by working with doctors, pharmacists and patients/carers. From this, we developed an intervention to support and encourage proactive deprescribing and have tested it in a feasibility study.
Twenty four hospitals in England will take part in a definitive trial to evaluate the effectiveness of the intervention compared to usual care – these hospitals will begin as control sites and advance to receive the intervention at different stages in a stepped wedge design. We will collect data throughout, including 4 weeks of detailed patient data pre and post implementation.
REC name
Wales REC 2
REC reference
23/WA/0184
Date of REC Opinion
22 Jun 2023
REC opinion
Favourable Opinion