Deprescribing in a Long Term Care Facility
- Conditions
- Polypharmacy
- Interventions
- Other: Medication Review
- Registration Number
- NCT03091153
- Lead Sponsor
- Memorial University of Newfoundland
- Brief Summary
This study will develop, implement and evaluate a deprescribing initiative at a Canadian Long Term Care (LTC) Facility. Residents currently undergo an annual medication review as part of the clinical pharmacy services provided in the LTC facility. For this study, eligible residents will be randomized to receive either a deprescribing focused medication review or usual care.
The deprescribing focused medication therapy assessments will be done on half of the 143 residents residing on the second and third floors of the facility. The other half of residents will serve as the control group and continue to receive their annual medication review and regular care from the attending physicians and nurses.
The deprescribing intervention will be delivered by final year pharmacy students completing their practice experiences, under the supervision of clinical pharmacists at the LTC facility and clinical pharmacists from Memorial University's Medication Therapy Services (MTS) Clinic. Currently the clinic has a well developed procedure for providing in depth medication therapy reviews for residents of the community, upon referral by their primary care physician. Students will adapt this model of medication review to have a stronger deprescribing focus and be applicable to elderly residents of a LTC facility. The intervention will consist of an in depth medication therapy review with a focus on identifying any medications that may no longer be required or are deemed to be inappropriate or potentially unsafe in the elderly based on currently guidelines/criteria. The students will work closely with members of the resident's care team on a daily basis, as well as the resident and their family, to develop and implement a deprescribing plan.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 67
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention Medication Review In depth medication review with a focus on deprescribing
- Primary Outcome Measures
Name Time Method Change in number of medications taken daily by residents 3 and 6 months after receiving intervention Measured using facility medication logs and patient health records
- Secondary Outcome Measures
Name Time Method Independence in activities of daily living 3 and 6 months after receiving the intervention Measured using the Activities of Daily Living Scale (ADL) obtained from RAI MDS 2.0
Social engagement 3 and 6 months after receiving the intervention Measured using Index of Social Engagement (ISE) Score obtained from RAI MDS 2.0
All cause mortality rate 3 and 6 months after receiving the intervention Measured using patient health records
Bowel function baseline, 3 and 6 months after receiving the intervention Measured using bowel chart data for the 14 days prior to the assessment date
Instance of falls in the last 30 days 3 and 6 months after receiving the intervention Measured using facility fall report logs
Frequency of emergency room visits, unplanned hospital admission and/or unplanned GP visits 3 and 6 months after receiving the intervention Measured using patient health records
Cognitive function score 3 and 6 months after receiving the intervention Measured using Cognitive Performance Scale (CPS) obtained from Resident Assessment Instrument (RAI) MDS 2.0
Frequency of pain 3 and 6 months after receiving the intervention Measured using the Pain Scale obtained from RAI MDS 2.0
Changes in general health 3 and 6 months after receiving the intervention Measured using the Changes in Health, End-Stage Disease and Signs and Symptoms (CHESS) Score obtained from RAI MDS 2.0
Aggressive behaviour 3 and 6 months after receiving the intervention Measured using the Aggressive Behaviour Scale (ABS) obtained from RAI MDS 2.0
Trial Locations
- Locations (1)
St Patrick's Mercy Home
🇨🇦St. John's, Newfoundland and Labrador, Canada