NCT03162081

Medication Misuse and Dependence Among Elderly

Medication Misuse and Dependence in Elderly Patients

• Status: Active Not Recruiting
• Phase: —
• Study type: Observational
• Enrollment: 500 (estimated)
• Sponsor: University Hospital, Akershus · Academic / Other
• Sex: All
• Age: 65 Years – 90 Years
• Healthy volunteers: Not accepted

Summary

The project focuses on investigating problematic medication use, especially overuse of potentially addictive drugs among the elderly. The investigators aim firstly to develop and validate instruments for detecting and describing behavioral aspects and consequences of dependence on, and misuse of, prescription medication among elderly. In addition to evaluating diagnostic utility of screening instruments, the investigators aim to identify and report characteristics, risk factors and consequences of medication misuse and dependence among the elderly.

Detailed description

Elderly represent a particularly vulnerable group with many contributing factors including age-related multifactorial morbidity, cognitive function, polypharmacy, dependence and multiple prescribers with suboptimal communication. Centrally active pain killers and sedative/hypnotic medications give increased risk of addiction, adverse drug events, reduced physical and/or cognitive function. The project comprises diagnostic accuracy, descriptive screening, cross-sectional and case-control studies, with aims to: i) assess diagnostic utility of instruments for elderly patients; ii) describe risk factors for medication misuse and dependence; iii) describe consequences of the use of centrally active medications among elderly compared to a control population. Moreover, the investigators aim to examine the association between medication misuse and changes in cognitive function, focusing on deficits in specific domains of cognition. An additional aim is to explore the possibility of dissociating such cognitive changes from other causes of mild cognitive impairment (MCI) associated with development of dementia.

Conditions

• Mild Cognitive Impairment
• Elderly
• Substance-Related Disorders

Interventions

Type	Name	Description
DIAGNOSTIC_TEST	Substance misuse screening	Diagnostic and Statistical manual of mental disorders, version 4 (DSM-IV)/MINI-international Neuropsychiatric interview (MINI interview) for Diagnostics of dependence, additional questions for DSM-V classification, severity of dependence scale (SDS)
DIAGNOSTIC_TEST	EQ-5D	Health related Quality of life
DIAGNOSTIC_TEST	Impulsivity screening	Barratts impulsivity test v. 11, Behavioural inhibition/behavioural activation test
DIAGNOSTIC_TEST	Cognitive screening	Minimental state examination (MMSE), Hospital anxiety and depression scale (HADS), Trail-making test, clock drawing test
DIAGNOSTIC_TEST	Functional tests	Timed up and go (TUG), Single leg balancing test (SLB)
DIAGNOSTIC_TEST	Cognistat	Assessment of cognitive domains
DIAGNOSTIC_TEST	Neuropsychological profiling	Controlled Oral Word Association Test, Categorical fluency tests, Wechsler Adult Intelligence Scale, Color-Word Interference Test (CWIT) from the Delis-Kaplan Executive Function test
OTHER	Clinical interview	Interview for sociodemographics, utilisation of health care, economic varables, The De Jong Gierveld Loneliness Scale
OTHER	Medication use	Detailed screen of used medications, interactions, side effects in electronic patient registry
OTHER	Comorbidity	Charlson comorbidity index and Cumulated illness rating scale (CIRS) based on electronic patient registry

Timeline

• Start date: 2017-05-03
• Primary completion: 2021-02-01
• Completion: 2024-12-31
• First posted: 2017-05-22
• Last updated: 2024-09-04

Locations

1 site across 1 country: Norway