Multidisciplinary intervention to improve medication safety in nursing home residents: protocol of a cluster randomised controlled trial (HIOPP-3-iTBX study)

Krause, Olaf; Wiese, Birgitt; Doyle, Ina-Merle; Kirsch, C.-M.; Thürmann, Petra A.; Wilm, Stefan; Sparenberg, Lisa; Stolz, Regina; Freytag, Antje; Bleidorn, Jutta; Junius-Walker, Ulrike

doi:10.1186/s12877-019-1027-0

Cited by 19 publications

(21 citation statements)

References 37 publications

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“…Various interventions have been used to improve medication safety in RACFs. These include pharmacist‐led medication reviews, improved interprofessional collaboration, providing training to staff, and the use of information technology (IT) 11 . Evidence indicates that pharmacists can reduce potentially inappropriate prescriptions and adverse health outcomes in older people across a range of healthcare facilities by systematically employing validated instruments or tools 12–15 …”

Section: Introductionmentioning

confidence: 99%

Pharmacist‐led interventions to reduce adverse drug events in older people living in residential aged care facilities: A systematic review

Salahudeen

Bereznicki

Curtain

2021

Brit J Clinical Pharma

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Aims We aimed to investigate the efficacy and effectiveness of pharmacist‐led interventions to reduce adverse drug events (ADEs) in older people living in residential aged care facilities (RACFs). Methods We systematically searched MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials and PsycINFO from their inceptions to July 2020. We investigated experimental study designs that employed a control group, or quasi‐experimental studies conducted in RACFs. Results We screened 3826 records and included 23 studies. We found seven single‐component and 16 multicomponent pharmacist‐led interventions to reduce ADEs in older people living in RACFs. The most frequent single‐component pharmacist‐led intervention was medication review. Medication review and education provision to healthcare professionals were the most common components in many pharmacist‐led multicomponent interventions. Thirteen studies (56%) showed no effect, whereas ten studies (43%) reported significant reductions in ADEs following pharmacist‐led interventions either as a sole intervention or as a part of a multi‐component intervention. Many interventions focused on reducing the incidence of falls (39%). Conclusions This systematic review suggests that pharmacist‐led interventions have the potential to reduce the incidence of ADEs in older people living in RACFs. Medication review and educational programmes, particularly academic detailing, either as a single component or as part of multicomponent interventions were the most common approaches to reducing drug‐related harm in older people living in RACFs. The lack of a positive association between interventions and ADE in many studies suggests that targeted and tailored pharmacist‐led interventions are required to reduce ADEs in older people in RACFs.

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Section: Introductionmentioning

confidence: 99%

Pharmacist‐led interventions to reduce adverse drug events in older people living in residential aged care facilities: A systematic review

Salahudeen

Bereznicki

Curtain

2021

Brit J Clinical Pharma

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“…Several studies have shown the effectiveness of comprehensive medication reviews in older people in reducing the number of medication-related problems and PIM use [ 5 , 6 , 7 , 8 , 9 ]. Over the past two decades, several evidence-based screening tools have been developed to avoid PIM use in older patients and prevent medication-related harms [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

et al. 2021

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Few studies have been conducted on multimorbidity (two or more chronic diseases) and rational geriatric prescribing in Africa. This study examined the prevalence and determinants of multimorbidity, polypharmacy (five or more long-term medications), and potentially inappropriate medication (PIM) use according to the 2019 Beers criteria among the older adults attending chronic care clinics from a single institution in Ethiopia. A hospital-based cross-sectional study was conducted among 320 randomly selected older adults from 12 March 2020 to 30 August 2020. A multivariable logistic regression analysis was performed to identify the predictor variables. The prevalence of multimorbidity, polypharmacy, and PIM exposure was 59.1%, 24.1%, and 47.2%, respectively. Diuretics (10%), insulin sliding scale (8.8%), amitriptyline (7.8%), and aspirin (6.9%) were among the most frequently prescribed PIMs. Older patients experiencing pain flare-ups were more likely to have multimorbidity (adjusted odds ratio (AOR): 1.64, 95% confidence intervals: 1.13–2.39). Persistent anger (AOR: 3.33; 1.71–6.47) and use of mobility aids (AOR: 2.41, 1.35–4.28) were associated with polypharmacy. Moreover, cognitive impairment (AOR: 1.65, 1.15–2.34) and health deterioration (AOR: 1.61, 1.11–2.32) increased the likelihood of PIM exposure. High prevalence of multimorbidity and PIM use was observed in Ethiopia. Several important determinants that can be modified by applying PIM criteria in routine practice were also identified.

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“…Research on medical care in nursing homes and its health consequences is meanwhile addressed by several on-going studies [ 44 , 49 – 51 ]. Moreover, the German legislation on long-term care recently underwent extensive changes including strengthening the role of nursing homes in establishing cont(?…”

Section: Discussionmentioning

confidence: 99%

Claims data analysis of medical specialist utilization among nursing home residents and community-dwelling older people

Schulz

Tsiasioti

Czwikla

et al. 2020

BMC Health Serv Res

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Background: Most older people, and especially those in need of long-term care, suffer from one or more chronic diseases. Consequently, older people have an increased need of medical care, including specialist care. There is little evidence as yet whether older people with greater medical care needs obtain adequate medical care because existing studies do not sufficiently control for differences in morbidity. In this study we investigate whether differences in medical specialist utilization exist between older people with and without assessed long-term care need in line with Book XI of the German Social Code, while at the same time controlling for individual differences in morbidity. Methods: We used data from the 11 German AOK Statutory Health and Long-term Care Insurance funds of 100,000 members aged 60 years or over. Zero-inflated Poisson regression analyses were applied to investigate whether the need for long-term care and the long-term care setting are associated with the probability and number of specialist visits. We controlled for age, gender, morbidity and mortality, residential density, and general practitioner (GP) utilization. Results: Older people in need of long-term care are more likely to have no specialist visit than people without the need for long-term care. This applies to nearly all medical specialties and for both care settings. Yet, despite these differences in utilization probability the number of specialist medical care visits between older people with and without the need for long-term care is similar. Conclusion: Older people in need of long-term care might face access barriers to specialist care. Once a contact is established, however, utilization does not differ considerably between those who need long-term care and those who don't; this indicates the importance of securing an initial contact.

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Multidisciplinary intervention to improve medication safety in nursing home residents: protocol of a cluster randomised controlled trial (HIOPP-3-iTBX study)

Cited by 19 publications

References 37 publications

Pharmacist‐led interventions to reduce adverse drug events in older people living in residential aged care facilities: A systematic review

Pharmacist‐led interventions to reduce adverse drug events in older people living in residential aged care facilities: A systematic review

Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

Claims data analysis of medical specialist utilization among nursing home residents and community-dwelling older people

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