The Interprofessional Medication Assessment for Older Patients

Not Applicable

• Conditions: Multimorbidity; Polypharmacy

• Registration Number: NCT02398812
• Lead Sponsor: East Savo Hospital District

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.

Study Timeline

• Study Start: 2015-02
• Study First Submitted: 2015-03-13
• Study First Submitted QC: 2015-03-20
• Study First Posted: 2015-03-26
• Status Verified: 2016-06
• Primary Completion: 2016-06
• Last Update Submitted: 2016-06-10
• Last Update Posted: 2016-06-13
• Study Completion: 2018-12

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 514

Inclusion Criteria

Home dwelling ≥65 years-old persons registered to public home care services and who

1. have had dizziness, orthostatic hypotension or have fallen or
2. 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).

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Functional capacity IADL (Instrumental Activities of Daily Living)	at 6 months from baseline
Functional capacity ADL (Activities of daily living;KATZ)	at 6 months from baseline
Functional capacity MMSE ( Mini-mental state examination)	at 6 months from baseline
Functional capacity TUG (Timed up and go)	at 6 months from baseline
Functional capacity GDS (Geriatric Depression Scale)-15	at 6 months from baseline

Secondary Outcome Measures

Name	Time	Method
Use of health care services	at 6 and 12 months from baseline	visits to physician, hospital days and nursing care at home
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
Number of medicines	at 6 and 12 months from baseline

Trial Locations

Locations (5)

Welfare district of Forssa; 🇫🇮 Forssa, Finland

Selänne Basic Health Care District; 🇫🇮 Haapajärvi, Finland

Juva Health Care; 🇫🇮 Juva, Finland

City of Lahti, home care; 🇫🇮 Lahti, Finland

Eastern Savo Hospital District; 🇫🇮 Savonlinna, Finland