Randomised, Controlled Trial of an Individual Deprescribing Intervention for Nursing Homes Residents

Not Applicable

Completed

Brief Summary: This study will evaluate the effects of a pharmacist-led, deprescribing-focused medication review on the use of inappropriate medications by nursing home residents

Detailed Description: Nursing home residents are often prescribed inappropriate medication, drugs whose negative effects outweigh potential benefits or which are not useful anymore. Inappropriate medication have been linked with worse health outcomes, hospitalisations and death. Deprescribing, the structured process of withdrawing or tapering inappropriate medications, has been studied as a potential solution to this problem.

In this study, nursing home residents living in institution which are already engaged in a deprescribing process will be randomly allocated to receive a medication review or usual care. The medication review will be performed by the nursing home pharmacist an its results will be discussed with the responsible physicians and nurses to create a deprescribing plan specifically tailored to the needs of the resident.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Physician judges that discussing deprescribing with them risks destabilising them.

Arm && Interventions

Group	Intervention	Description
Individual Deprescribing Intervention	Individual Deprescribing Intervention	Participants allocated to the intervention arm will receive the Individual Deprescribing Intervention (pharmacist-led medication review, followed by the creation of a deprescribing plan by the pharmacist, physician and responsible nurse).

Primary Outcome Measures

Name	Time	Method
Number of Inappropriate Medication at Follow-up	4 months	Number of inappropriate medications prescribed at follow-up, assessed using the French translation of STOPP v2.

Secondary Outcome Measures

Name	Time	Method
Number of Chronic DDDs Prescribed to Participants	4 months	Number of chronic DDDs prescribed to participants
Number of Common Drug-related Complaints at Follow-up	4 months	Number of common drug-related complaints at follow-up
Number of Potentially Inappropriate DDDs Prescribed to Participants at Follow-up	4 months	Appropriateness assessed using the French translation of STOPP v2; DDD defined by WHO.
Number of New Drugs Prescribed as a Result of the Intervention	4 months	This outcome was not analysed
Number of Chronic Drugs Prescribed to Participants	4 months	Number of Chronic Drugs Prescribed to Participants
Health-related Quality of Life	4 months	The EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) tool was used to assess quality of life; this tool includes * a visual analog scale, ranging from 0 to 100, 100 indicating "the best health you can imagine" and 0 "the worst health you can imagine". Higher results indicate an higher quality of life. * 5 questions, each with 5 possible answers. Using a valuation set, the answers to individual questions were transformed in a numeric index value for each participants, with a maximum of 1 and an infinitely low minimum. Higher values indicates higher perceived health-related quality of life.