Team Approach to Polypharmacy Reduction to Improve Mobility (TAPER-Mobility): A Pilot Feasibility Study in a Long-Term Care Setting
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Successful Discontinuation (Difference in Mean Number of Medications; Reduction in Dose)
研究概览
简要总结
Medication side effects and interactions between medications are very common in older adults and are related to negative health outcomes, including mobility. In this study, the investigators will test a new process aimed at reducing unnecessary medication use and drug side effects in seniors using the best medical evidence and patient preferences for treatment. This study will assess how feasible the implementation of this intervention is within a long-term care facility as well as if it is possible. The study will also assess for any signals of reversal of medications related mobility impairments to reduce medications-related mobility impairment (fatigue, pain, falls) using the intervention. Participants in two long-term care facilities will participate in this study. Measures will include feasibility outcomes regarding the logistics of the intervention as well as patients outcomes (falls, hospitalizations, and medications) collected before and after implementation. Findings will inform the design of a randomized controlled trial to test the effect of this intervention on health outcomes.
详细描述
There are substantial associations between polypharmacy and reduced function from older adults and this is likely to be important in frail older adults both in long term care and in the community. The reversibility of drug-induced mobility impairment is unclear therefore the investigators plan to investigate signals of any impact of reducing polypharmacy on mobility. The investigators chose the long-term care setting given the presence of complete medication administration records and this patient population's high prevalence of polypharmacy and risk of adverse drug events. TAPERMD is an electronic tool for systematic medication reduction that incorporates patient priorities, electronic screening for potentially harmful medicines, supporting evidence tools and a monitoring pathway to support medication reduction. This study will examine the feasibility of this tool in a long-term care setting as well as examine. Participants in two long-term care facilities will participate in this study. Measures will include feasibility outcomes regarding the logistics of the intervention as well as patients outcomes (falls, hospitalizations, and medications) collected before and after implementation. Findings will inform a randomized controlled trial to measure the effect of this intervention on health outcomes.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 70 Years 至 —(Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •residing in 2 long-term care facilities in Brampton, ON
- •on 5 or more medications
- •70 years of age or older
- •adequate English language
排除标准
- 未提供
结局指标
主要结局
Successful Discontinuation (Difference in Mean Number of Medications; Reduction in Dose)
时间窗: 6 months
Difference in mean number of medications; number of medications reduced in dose
次要结局
- Mobility-related Fatigue(Baseline, 6 months)
- Level of Physical Functioning(Baseline, 6 Months)
- Pain(Baseline, 6 Months)
- Falls(Baseline, 6 Months)
- Sleep(Baseline, 6 Months)
- Serious Adverse Events(1-week, 3-month, 6-month)
- Quality of Life(Baseline, 6-months)
- Decrease in Medication Side Effects and Symptoms(1-week, 3-month, 6-month)
- Performance of Activities of Daily Living(Baseline, 6-months)
- Strength(Baseline, 6-months)
- Healthcare Utilization(Baseline, 6-months)
- Feasibility Outcomes(Baseline, 6 months)
- Physical Functioning Performance(Baseline, 6-months)
- Functional Ability(Baseline, 6-months)
