A New Interdisciplinary Collaboration Structure to Improve Medication Safety in the Elderly
- Conditions
- Health Services for the AgedMedication Therapy Management
- Interventions
- Other: Interdisciplinary collaboration structure
- Registration Number
- NCT02816086
- Lead Sponsor
- University of Tromso
- Brief Summary
Suboptimal use of medications among geriatric patients is well-known problem and leads to medication errors, re-hospitalizations and death. By using a randomized controlled trial (RCT) design the investigators aim to explore a new inter-professional working structure. The working structure is based on the scientifically and clinically acknowledged integrated medicines management (IMM) model. The overall aim of the study is to explore the effect of the new working structure on the composite endpoint re-hospitalization + visit to an emergency department during 12 months after hospital discharge.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 516
- Aged ≥70 years
- Admitted to the geriatric internal medicine ward in the University Hospital of North Norway (UNN) Tromsø or the general internal medicine ward in UNN Harstad.
- Willing to provide written informed consent during hospital stay (patient or next of kin)
- Unable to communicate in Norwegian (patient or next of kind)
- Terminally ill, e.g cancer in end-life stage
- Control group patients where the physician request an assessment from a pharmacist
- Time from admittance to the ward to inclusion is more than 72 hours
- Occupying a bed in the study wards but under the care of physicians from a non-study ward.
- Planned discharged on the inclusion day
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention Interdisciplinary collaboration structure Interdisciplinary collaboration structure
- Primary Outcome Measures
Name Time Method Emergency medical visits 12 months after hospital discharge Rate of emergency Medical visits at 12 months. Emergency Medical visits is a composite endpoint including emergency department visits and unscheduled hospitalization
- Secondary Outcome Measures
Name Time Method The proportion of patients readmitted acutely within 30 days 30 days after discharge from index hospital stay Potentially inappropriate prescribing identified through the Screening Tool to Alert doctors to Right treatment (START) Baseline at randomization Change in potentially inappropriate prescribing identified through the Screening Tool to Alert doctors to Right treatment (START) From baseline to date of discharge from hospital, assessed up to 12 months Change in Inappropriate medications identified through the Norwegian general practice criteria (NORGEP) From baseline to date of discharge from hospital, assessed up to 12 months Time to first rehospitalization First rehospitalization after discharge from index hospital stay, up to 12 months after discharge. Days to first hospitalization
Total score of the Medication appropriateness index (MAI) Baseline at randomization Mortality rate 12 months after randomization Potentially inappropriate prescribing identified through the Screening Tool of Older Persons' Prescriptions (STOPP) Baseline at randomization Changes in medication, identified through screening of drug lists at their primary care physician. 3 months after discharge from index hospital stay Drug changes made during hospitalization implemented by the primary care physician.
Rehospitalizations where the reason for hospitalization is possibly, probably or certainly drug-related. First rehospitalization after discharge from index hospital stay, up to 12 months after inclusion in study A chart review will be done retrospectively to evaluate if the patients first rehospitalization was drug related or not. Classified by a multiprofessional team of experts
Self-reported quality of life 12 months after hospital discharge Change in self-reported quality of life using the validated EQ-5D
length in days of index hospital stay Days from hospitalization to discharge of index hospital stay, assessed up to 12 months Days from hospital admission to discharge of index hospital stay
Change in total score of the Medication appropriateness index (MAI) From baseline to date of discharge from hospital, assessed up to 12 months Inappropriate medications identified through the Norwegian general practice criteria (NORGEP) Baseline at randomization Visits to primary care physician 12 months after discharge for index hospital stay Visitation rate at 12 months
Change in inappropriate medications identified through the Norwegian general practice criteria (NORGEP) From baseline to 3 months after discharge from index hospital stay, assessed up to 12 months Hip fracture 12 months after discharge from index hospital stay Rate of hip fractures
Stroke 12 months after discharge from index hospital stay Stroke rate during 12 months follow-up
Change in potentially inappropriate prescribing identified through the Screening Tool of Older Persons' Prescriptions (STOPP) From baseline to 12 months after discharge from hospital
Trial Locations
- Locations (1)
University hospital of North Norway
🇳🇴Tromso, Norway