The Interprofessional Medication Assessment for Older Patients - a Multicenter Randomized Trial in Primary Care Setting
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Multimorbidity
- Sponsor
- East Savo Hospital District
- Enrollment
- 514
- Locations
- 5
- Primary Endpoint
- Functional capacity IADL (Instrumental Activities of Daily Living)
- Last Updated
- 9 years ago
Overview
Brief Summary
The objective of this pragmatic multi-center randomized controlled trial is to test the effectiveness of interprofessional medication assessment in older patients needing home care due to their diseases or decreased functional capacity in primary care. The main hypothesis is that intervention has a positive impact on functional capacity and for rational and safe use of medicines.
Detailed Description
Aging increases the risk of adverse effects and interactions caused by medication. Medication reconciliation and medication review are well-known practices to optimize medicines use. Both interventions usually require a team-based approach to be effective. Medication reconciliation is the process of obtaining and documenting a complete and accurate list of current patient medications and comparing this list with medication orders at each point of care transition to identify and rectify any discrepancies before patient harm occurs. Medication review is the process of evaluating current medication treatment to manage the risk and optimize the outcomes of medication treatment by detecting, solving, and preventing medication-related problems. The present study focuses on medication assessment including both medication reconciliation and review combined to clinical assessment of an individual patient. According to a systematic review there is a need for research focusing on medication management in community settings and especially to assess the impact of medication assessment on clinical outcomes.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Home dwelling ≥65 years-old persons registered to public home care services and who
- •have had dizziness, orthostatic hypotension or have fallen or
- •use at least six medicines
Exclusion Criteria
- •Home care is not responsible for patient's medication, for example due to severe chronic illness (for example severe renal insufficiency or cancer with active treatment in secondary or tertiary care).
Outcomes
Primary Outcomes
Functional capacity IADL (Instrumental Activities of Daily Living)
Time Frame: at 6 months from baseline
Functional capacity ADL (Activities of daily living;KATZ)
Time Frame: at 6 months from baseline
Functional capacity MMSE ( Mini-mental state examination)
Time Frame: at 6 months from baseline
Functional capacity TUG (Timed up and go)
Time Frame: at 6 months from baseline
Functional capacity GDS (Geriatric Depression Scale)-15
Time Frame: at 6 months from baseline
Secondary Outcomes
- Number of medicines(at 6 and 12 months from baseline)
- Use of health care services(at 6 and 12 months from baseline)
- Quality of medicines(at 6 and 12 months from baseline)
- Health related quality of life assessed with EQ-5D(at 6 and 12 months from baseline)
- Cost of medicines(at 6 and 12 months from baseline)
- Need of services delivered to home(at 6 and 12 months from baseline)