An Intervention Study to Reduce Drug-related Problems and Readmissions Among Old People With Dementia

Not Applicable

Completed

Conditions: Cognitive Impairment

Interventions: Other: Medication review

Registration Number: NCT01504672

Lead Sponsor: Umeå University

Brief Summary: The aim of this randomized controlled study is to investigate if medication reviews performed by a clinical pharmacist as part of a ward team can reduce drug related problems and reduce readmissions to hospital among elderly patients (≥65 years) with dementia and cognitive failure.

Four hundred and sixty patients will be recruited and randomized to control (usual care) and intervention group (enhanced service in which a pharmacist is part of the health care team).

Six months after the last patient of the 460 has been discharged the study will be closed. Data about the number of readmissions and visits to the emergency room will be collected during the six-month follow-up and also, the costs associated with each visit or admission. Time until institutionalization will be compared between intervention group and control group.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 460

Inclusion Criteria

Patients with dementia or cognitive impairment
Patients ≥ 65 years

Exclusion Criteria

Patients previously admitted to the study wards during the study period

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Medication review	Medication review	-

Primary Outcome Measures

Name	Time	Method
Number of Patients Readmitted Because of Drug Related Reasons	Six months follow-up

Secondary Outcome Measures

Name	Time	Method
Frequency of Emergency Department Visits During the 6-month Follow-up.	Six months follow-up
Change in the Number of Participants With Potentially Inappropriate Medications, According to the Swedish National Board of Health and Welfare, at Admission and Discharge Between Intervention and Control Group	Index admission (at randomization) and index discharge (duration of index admission, mean days 8.7)	Six drug-specific quality indicators as defined by the Swedish National Board of Health and Welfare were used to define use of Potentially inappropriate medications (PIMs) in this study. Four out of the six selected indicators belong to a group where drug-use should be as low as possible regardless of indication: anticholinergic drugs (as defined by the Swedish National Board of Health and Welfare, propiomazine, tramadol, and long-acting benzodiazepines. The two remaining indicators are classified as preparations for which correct and current indication is of particular importance: antipsychotic drugs (N05A except lithium) and Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). In the present study, a PIM was defined as exposure to at least one of the drugs mentioned among the six quality indicators.
Cost for Visits for Readmissions and to the Emergency Department Compared Between Patients in the Control Group and Intervention Group.	Six months follow-up	To evaluate the economic impact of clinical pharmacist engagement in hospital ward teams for medication therapy management in older patients with dementia or cognitive impairments.
Number of Participants Institutionalized After Discharge, in Control Group and Intervention Group.	Six months follow-up