Discontinuing Inappropriate Medication in Nursing Home Residents (the DIM NHR Study): a Cluster Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Polypharmacy Because of Multimorbidity in Geriatric Nursing Home Residents
- Sponsor
- University of Groningen
- Enrollment
- 992
- Locations
- 1
- Primary Endpoint
- Successful medication discontinuation
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
Nursing home residents are among the frailest patient groups with a high number of co-morbidities and a high use of medicines. Inappropriate polypharmacy (i.e. often overprescribing) is one of the major problems in the nursing home population increasing the number of adverse drug reactions, falls, hospital admissions, mortality as well as having an impact on health care utilization. Multidisciplinary medication reviews have a great potential to reduce inappropriate medication use. The purpose of this study is to determine the efficacy of a multidisciplinary medication review model focussing on discontinuing inappropriate medication in a cluster randomized controlled trial in 600 nursing home residents. The primary outcome measure is the difference in proportion of residents who successfully discontinued medication between intervention and control group after four months. Secondary outcome measures will be the drug burden index, adverse drug withdrawal events related to the discontinued medication, death, referral to hospitals and quality of life.
Investigators
Katja Taxis
Professor of Pharmacotherapy and Clinical Pharmacy
University of Groningen
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Successful medication discontinuation
Time Frame: 4 months
The number of residents for whom ≥1 inappropriate medication(s) are succesfully discontinued i.e. without relapse or severe withdrawal effects
Secondary Outcomes
- Dose adjustment(4 months)
- Death(4 months)
- Safer alternative medication(4 months)
- Bone fractures(4 months)
- Drug burden index(4 months)
- Quality of Life(4 months)
- adverse drug withdrawal events(4 months)
- Hospital admission(4 months)
- Falling(4 months)
- number of visits to outpatient clinics / emergency rooms / by medical consultants(4 months)
- Medication initiation(4 months)