Opportunities and Limits to Deprescribing in Nursing Homes:Quality Circle Deprescribing Module

Not Applicable

Completed

Brief Summary: Older people residing in nursing homes (NH) are frequently polymedicated and often prescribed potentially inappropriate medications. Deprescribing has been proposed as a way to reduce the number of drugs they receive and their exposure to harmful treatments.

The objectives of this study are 1) To evaluate the effect of a deprescribing-specific interdisciplinary quality circle module on the use of potentially inappropriate medication in nursing-home residents. 2) To determine the effective strategies to reach and implement deprescribing consensus resulting of said quality circle module.

Recruitment & Eligibility

Inclusion Criteria

Nursing homes taking part in the study must have

a geriatric of psycho-geriatric mission;
been part of their cantonal pharmaceutical assistance program for at least a year.

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Intervention	Quality Circle Deprescribing Module	Nursing Homes allocated to the Intervention arm will enact the Quality Circle Deprescribing Module and create a local deprescribing consensus and implementation strategy.

Primary Outcome Measures

Name	Time	Method
Percentage of Potentially Inappropriate Galenic Units	12 months	The primary outcome is the percentage, at follow-up, of potentially inappropriate galenic units at follow-up, relative to the total number of galenic units used in the nursing home.
Number of Potentially Inappropriate Defined Daily Doses (DDDs) Per Average Resident and Per Day	12 months	Sum of Defined Daily Doses identified as potentially inappropriate (PIM, see protocol for assessement method), divided by the total number of days spent in the NH

Secondary Outcome Measures

Name	Time	Method
Number of Falls Per Average Resident and Per Year	12 months	Number of falls per average resident and per year
Number of Potentially Inappropriate DDD to Avoid	12 months	Sum of Defined Daily Doses identified as "to avoid" (see protocol for assessement method), divided by the total number of days spent in the NH.
Number of Potentially Inappropriate DDD to Reevaluate	12 months	Sum of Defined Daily Doses identified as "to reevaluate" (see protocol for assessement method), divided by the total number of days spent in the NH.
Number of Hospital Days	12 months	The number of days spent in the hospital by average resident
Mortality Rate	12 months	Number of residents of the nursing home having died during the considered year, divided by the total number of residents having stayed in the nursing home.
Percentage of Residents With at Least One Day of Physical Restraints Use	12 months	Number of residents of the nursing home with at least one day of physical restraints use during the considered year, divided by the total number of residents having stayed in the nursing home.