Underprescribing in Geriatric Patients: a Prevalence Study and Analysis of Factors Contributing to Potential Prescription Omissions (Under-PRES)

This observational study will determine the prevalence of underprescription in a cohort of elderly patients, recruited at the time of an outpatient geriatric visit, or hospitalized, upon admission to a geriatric ward.

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Key information

Conditions

Older People

Age range

65 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

IRCCS INRCA Hospital, Ancona, Italy

About this study

Polypharmacy in older patients is associated with both inappropriate drug prescribing and underprescription or omission of appropriate medications. Potential prescriptive omission (PPO), defined as the underprescription of potentially beneficial drugs, is increasing across all care settings and is associated with adverse clinical outcomes. However, in some cases, PPO may represent a legitimate medical decision.

The aim of this study is to investigate the phenomenon of underprescription by differentiating between justified and inappropriate potential prescriptive omissions (PPOs) in elderly patients in both hospital and outpatient settings, using the Screening Tool to Alert to Right Treatment (START) criteria, version 3.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Geriatric ward admission or outpatient geriatric appointment
Capacity to provide informed consent by the patient or legal guardian

Exclusion criteria

Limited life expectancy as measured by the Clinical Frailty Scale (CFS) >8

Treatment and study plan

Primary outcomes

Rate of potential prescription omissions (PPOs)

Time frame: at baseline and 3 months later

Prevalence of potential prescription omissions (PPOs) will be evaluated by Screening Tool to Alert doctors to Right Treatment (START) criteria version 3 in aged patients enrolled on admission to geriatric departments of participating centers or during geriatric outpatient clinic visits

Secondary outcomes

Characterisation of the potential prescription omissions (PPOs)

Time frame: at baseline and 3 months later

The reasons for underprescription will be investigated to differentiate between justified and inappropriate potential prescriptive omissions (PPOs). Patients and/or their family members and/or the general practitioner will be interviewed to assess the potential reasons related to underprescription.

Study contacts

Contact information is provided by the study sponsor or research team.

Anna Rita Bonfigli

CONTACT

[email protected]

0718003719

Sponsors and collaborators

Lead sponsor

Istituto Nazionale di Ricovero e Cura per Anziani

Other

Registry information

Acronym: Under-PRES

Important dates

Study start: 2024
Primary completion: 2026
Study completion: 2026
First posted: Apr 1, 2025
Registry last updated: Apr 1, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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