Developing Pharmacist-led Research to Educate and Sensitive Community Residents to the Inappropriate Prescription Burden in the Elderly
Overview
- Phase
- Phase 4
- Intervention
- Not specified
- Conditions
- Inappropriate Dose of Drug Administered
- Sponsor
- Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal
- Enrollment
- 600
- Primary Endpoint
- Complete discontinuation of inappropriate prescriptions.
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
The objective of this trial is to test the beneficial effect of a pharmacist-initiated knowledge transfer intervention to both patients and prescribers on the discontinuation of inappropriate prescriptions, compared to usual care. The investigators hypothesize that the pharmacist-led intervention will reduce inappropriate prescriptions by at least 20% over 6-months compared to usual care. The intervention consists of simultaneously educating consumers and providing physicians with an evidence-based pharmaceutical opinion on inappropriate prescriptions.
Investigators
Cara Tannenbaum
Dr. Cara Tannenbaum
Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal
Eligibility Criteria
Inclusion Criteria
- •Men and women 65 years of age and older (no upper age limit)
- •Individuals for whom prescription claims derive from only one pharmacy identifier
- •Chronic consumption (\> 3 month claims) of one of the target inappropriate prescriptions. (benzodiazepine/non benzodiazepine hypnotic, long-acting sulfonylurea oral hypoglycemic agents, anticholinergic agents (in the form of first-generation antihistamines) or Nonsteroidal anti-inflammatory drugs \[NSAIDs\] )
- •Patients who are willing to participate in the study.
Exclusion Criteria
- •A probable diagnosis of dementia (persons without the capacity to provide informed consent), as determined by a) a prescription for memantine or a cholinesterase inhibitor; b) report from a caregiver or family-member; or c) a baseline screening score on the Folstein Mini-Mental State Exam \< 24
- •Inability to understand and or communicate in English and/or French
- •Patients living in a long-term care facility
- •Concomitant use of any antipsychotic medication
Outcomes
Primary Outcomes
Complete discontinuation of inappropriate prescriptions.
Time Frame: 6 months
Provincial prescription insurance claims will be used to measure whether the inappropriate prescription has been discontinued in the intervention and control group at 6-months. Prescription data contain information on all dispensed prescriptions including drug name, dispensation date, dosage, drug form, duration and quantity of the drug dispensed, as well as the license number of the physician who wrote the prescription. Discontinuation of an inappropriate prescription will be defined as the lack of a claims renewal for that medication during a minimum of three or more consecutive months (with no subsequent renewals) during the nine months following receipt of the intervention.
Secondary Outcomes
- The frequency, timing and type of pharmaceutical opinions sent by the pharmacist to the patient's primary care physician.(6 months)
- Effect of the pharmaceutical opinion on the prescriber's behaviour.(6 months)
- Patient-physician encounters to discuss inappropriate prescriptions.(6 months)