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- The drug therapy provided in nursing homes (NHs) can be improved by implementing a variety of measures: relying on the specialist expertise of the actors involved, careful prescribing by GPs, medication checks by pharmacists, and better information transfer and case conferences between GPs, pharmacists, and nurses.
bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08562-6
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Oct 22, 2021 · The aim of this study was to increase drug therapy safety by reducing the proportion of nursing-home residents using ≥ one PIM and/or ≥ two neuroleptic drugs through complex, multiprofessional interventions, including medication reviews.
- 10.3238/arztebl.m2021.0297
- 2021/10
Mar 9, 2021 · Polypharmacy, medication errors and adverse drug events are frequent among nursing home residents. Errors can occur at any step of the medication use process. We aimed to review interventions aiming at optimization of any step of medication use in nursing homes.
- Anne Spinewine, Perrine Evrard, Carmel Hughes
- 10.1007/s41999-021-00477-5
- 2021
- Eur Geriatr Med. 2021; 12(3): 551-567.
- Design and Setting of The Study
- Participants and Materials
- Recruitment Strategy
- Intervention
- Incentives
- Outcomes
- Sample Size
- Randomisation
- Blinding
- Data Collection Methods
The multicentre cluster randomised controlled trial (cRCT) is conducted in four geographical regions in Germany (Hannover, Rostock, Düsseldorf and Tübingen), of which two have a wide rural periphery and two are more urban based. Clustering takes place at the level of nursing homes. Together, the four study centres will include a total of 760 NHR at...
Study participants are NHR who are at least 65 years of age and living in long-term residential care facilities. Exclusion criteria are having a life expectancy of less than 6 months based on nurses’ judgement. In case of doubt or when a nurse’s judgement is not available, the NHR’ GPs are asked for their judgement. The eligibility criteria for nur...
The recruitment procedure is standardised and follows several steps. First, all nursing homes covering the four areas are informed about the study by mail (September 2017). Nursing homes expressing an interest are contacted by phone or personal visit in order to describe the study in more detail, to assess whether eligibility criteria are met and w...
Following baseline assessment (t0), the intervention will be conducted and its effects measured at 6 months follow-up (t1) (Fig. 1). The intervention consists of four elements. Firstly, the community pharmacists in charge of the nursing homes receive a special two-day training (ATHINA = Arzneimitteltherapiesicherheit in Apotheken i.e. medication th...
Pharmacists allocated to the intervention group as well as GPs receive a financial compensation per medication review. As part of the preparatory phase, the ATHINA training and HIOPP-3 training sessions are offered to all pharmacists allocated to the intervention group free of charge. Pharmacists allocated to the control group can receive the ATHIN...
The primary endpoint is the rate of PIM and/or antipsychotic drugs, which will be calculated based on the current medication data. The secondary endpoints/parameters are number of falls, emergency medical contacts, hospitalisation, quality of life and cognition of NHR. Moreover, health services utilisation is assessed for a health economics evaluat...
The sample size estimation is based on the assumption that a proportion of 50% of NHR receive PIM and/or ≥ 2 antipsychotics in Germany. This estimated figure is based on studies according to which 40% of NHR receive at least one PIM and 20% receive two and more antipsychotics simultaneously . We assume that an overlap of PIM and ≥ 2 antipsychotic ...
The randomisation is carried out as a cluster randomisation allocating the nursing homes either to the intervention or to the control group. Randomisation is performed by an experienced biometrician at Hannover Medical School after the recruitment of patients (BW). The allocation sequence is computer generated and concealed from researchers and int...
Due to the complex nature of the intervention, blinding of participants, health care providers and data collectors is not possible. The randomisation is performed after the recruitment of nursing homes, pharmacists, GPs and nursing home residents.
Resident-related data are collected by the study personnel via standardised questionnaires and additionally according to the NHR’s records. Then the data is entered into an internet based electronic data capture system at two time points: t0 after obtaining written informed consent and randomization and before starting the intervention, t1 after th...
- Olaf Krause, Birgitt Wiese, Ina-Merle Doyle, Claudia Kirsch, Petra Thürmann, Stefan Wilm, Lisa Spare...
- 2019
Oct 22, 2021 · Background: The safety of drug use by nursing-home residents can be impaired by polypharmacy, potentially inappropriate medications (PIM), and neuroleptics, as well as by a lack of adequate interprofessional coordination in the nursing home.
Jun 20, 2022 · SAFETY IN LONG-TERM CARE Looking forward, we believe several specific steps to improve medication safety could make care safer in older populations (figure 1). The first is adoption in long-term care of smart electronic health records which make it easy to track what medications people are taking, and which include more robust decision
The aim of this study was to increase drug therapy safety by reducing the proportion of nursing-home residents using ≥ one PIM and/or ≥ two neuroleptic drugs through complex,...
Technological advances and other administrative strategies may also improve resident safety. This perspective addresses issues in medication safety facing RACFs and methods to improve the safety of medicines for their residents. Keywords: inappropriate medications, medication safety, nursing home, pharmacist review, residential aged care. Go to:
