NCT01876095

Discontinuing Inappropriate Medication in Nursing Home Residents

Discontinuing Inappropriate Medication in Nursing Home Residents (the DIM NHR Study): a Cluster Randomized Controlled Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 992 (actual)
• Sponsor: University of Groningen · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Not accepted

Summary

Nursing home residents are among the frailest patient groups with a high number of co-morbidities and a high use of medicines. Inappropriate polypharmacy (i.e. often overprescribing) is one of the major problems in the nursing home population increasing the number of adverse drug reactions, falls, hospital admissions, mortality as well as having an impact on health care utilization. Multidisciplinary medication reviews have a great potential to reduce inappropriate medication use. The purpose of this study is to determine the efficacy of a multidisciplinary medication review model focussing on discontinuing inappropriate medication in a cluster randomized controlled trial in 600 nursing home residents. The primary outcome measure is the difference in proportion of residents who successfully discontinued medication between intervention and control group after four months. Secondary outcome measures will be the drug burden index, adverse drug withdrawal events related to the discontinued medication, death, referral to hospitals and quality of life.

Conditions

• Polypharmacy Because of Multimorbidity in Geriatric Nursing Home Residents

Interventions

Type	Name	Description
PROCEDURE	Multidisciplinary medication review	Consists of the following steps: * 1\. Elderly care physician and nursing staff evaluate with the patient the experience of taking medicines, adverse drug reactions and patient's preferences. * 2\. Pharmacist reviews medication to identify drug related problems using START/STOPP en Beers criteria. * 3/4. Meeting of elderly care physician, pharmacist. Possibilities to discontinue prescribed medication will be examined resulting in pharmaceutical care plan that optimizes the patient's medication i.e. which inappropriate medication should be discontinued following a prioritization and time schedule. * 5\. Execution of pharmaceutical care plan according to agreed schedule.

Timeline

• Start date: 2014-06-01
• Primary completion: 2016-04-01
• Completion: 2016-04-01
• First posted: 2013-06-12
• Last updated: 2017-03-22

Locations

1 site across 1 country: Netherlands