The REPOSI Registry (REgistro POliterapie SIMI) is a collaborative project between the Italian Society of Internal Medicine (Società Italiana di Medicina Interna, SIMI), the IRCCS Ca’ Granda Maggiore Policlinico Hospital Foundation of Milan and the IRCCS Istituto di Ricerche Farmacologiche Mario Negri of Milan.
The REPOSI Registry was designed in 2008 with the purpose of creating a network of internal medicine and geriatric wards in order to evaluate patients affected by multiple diseases and prescribed with polypharmacy. Participation in the network was on a voluntary basis, but in the choice of the participating centers, attention was given to their homogeneous composition in terms of geographic distribution, size and unselected admissions from the territory or the emergency room.
The specific aims of the REPOSI study were:
– to describe the prevalence of co-occurring multiple diseases and treatments in hospitalized elderly patients,
– to correlate clinical characteristics of the patients with type and number of diseases and treatments,
– to evaluate the main clinical outcomes at hospital discharge.
The original study design included two phases: phase one was designed to create the network of internal medicine and geriatric wards, and phase two was intended to activate a registry of patients included in the study.
A sample of at least 20 patients aged 65 years and older consecutively admitted to each participating hospital during a period of 4 weeks, 3 months apart each from the other, was enrolled in the study by each participating ward in three different years (2008, 2010, 2012. 2014 and from 2015 the Registry became permanent). The study was approved by the Ethical Committee of the IRCCS Ca’ Granda Maggiore Policlinico Hospital Foundation of Milan and an informed consent was signed by all patients.
The Figure below shows the network of REPOSI Italian wards who participated to the study in the period 2008-2016.
A standardized web-based case report form was filled in by the attending physicians for all enrolled patients, including socio-demographic characteristics, clinical parameters, diagnoses, comorbidity according to the Cumulative Illness Rating Scale (CIRS), basic activities of daily living according to the Barthel Index, cognitive impairment according to the Short Blessed Test, depression according to the Geriatric Depression Scale and medications prescribed at both hospital admission and discharge and clinical events during hospitalization. Telephone follow-up was performed 3 months (in 2010 and 2012) and 12 months (only for 2012) after hospital discharge collecting data on mortality, re-hospitalization, major adverse clinical events, disability and medications.
Until now the Registry has collected a sample of more than 6,000 hospitalized elderly patients. On 2014, a new wave of data collection has been started in 20 Spanish geriatric and internal medicine hospital wards.
In the table below some characteristics of the patients enrolled in 2008, 2010, 2012, 2014 and 2015 are summarized. Starting from May 2015 the Registry become a permanent registry that collect data one index week every 3 months. During these years, the REPOSI investigators have published 30 original articles and many abstracts/posters/presentations at international and national congresses.