An interventional study of Medication Review in Polypharmacy, sponsored by Memorial University of Newfoundland. Completed at 1 site in Canada. Open to participants aged 65 Years and older. Per ClinicalTrials.gov, last updated 2019-07-22.
Sponsored by Memorial University of Newfoundland · Not applicable, Interventional, and Treatment
This study will develop, implement and evaluate a deprescribing initiative at a Canadian Long Term Care (LTC) Facility. Residents currently undergo an annual medication review as part of the clinical pharmacy services provided in the LTC facility. For this study, eligible residents will be randomized to receive either a deprescribing focused medication review or usual care.
The deprescribing focused medication therapy assessments will be done on half of the 143 residents residing on the second and third floors of the facility. The other half of residents will serve as the control group and continue to receive their annual medication review and regular care from the attending physicians and nurses.
The deprescribing intervention will be delivered by final year pharmacy students completing their practice experiences, under the supervision of clinical pharmacists at the LTC facility and clinical pharmacists from Memorial University's Medication Therapy Services (MTS) Clinic. Currently the clinic has a well developed procedure for providing in depth medication therapy reviews for residents of the community, upon referral by their primary care physician. Students will adapt this model of medication review to have a stronger deprescribing focus and be applicable to elderly residents of a LTC facility. The intervention will consist of an in depth medication therapy review with a focus on identifying any medications that may no longer be required or are deemed to be inappropriate or potentially unsafe in the elderly based on currently guidelines/criteria. The students will work closely with members of the resident's care team on a daily basis, as well as the resident and their family, to develop and implement a deprescribing plan.
Memorial University of Newfoundland is the lead sponsor of 49 studies on the registry; 5 are open to participants now.
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Exclusion Criteria (any of the following):
Standard care. Annual medication review
In depth medication review with a focus on deprescribing
Other: Medication Review
In depth medication review with a focus on deprescribing
Change in number of medications taken daily by residents
Measured using facility medication logs and patient health records
Time frame: 3 and 6 months after receiving intervention
All cause mortality rate
Measured using patient health records
Time frame: 3 and 6 months after receiving the intervention
Instance of falls in the last 30 days
Measured using facility fall report logs
Time frame: 3 and 6 months after receiving the intervention
Frequency of emergency room visits, unplanned hospital admission and/or unplanned GP visits
Measured using patient health records
Time frame: 3 and 6 months after receiving the intervention
Cognitive function score
Measured using Cognitive Performance Scale (CPS) obtained from Resident Assessment Instrument (RAI) MDS 2.0
Time frame: 3 and 6 months after receiving the intervention
Bowel function
Measured using bowel chart data for the 14 days prior to the assessment date
Time frame: baseline, 3 and 6 months after receiving the intervention
Independence in activities of daily living
Measured using the Activities of Daily Living Scale (ADL) obtained from RAI MDS 2.0
Time frame: 3 and 6 months after receiving the intervention
Changes in general health
Measured using the Changes in Health, End-Stage Disease and Signs and Symptoms (CHESS) Score obtained from RAI MDS 2.0
Time frame: 3 and 6 months after receiving the intervention
Social engagement
Measured using Index of Social Engagement (ISE) Score obtained from RAI MDS 2.0
Time frame: 3 and 6 months after receiving the intervention
Aggressive behaviour
Measured using the Aggressive Behaviour Scale (ABS) obtained from RAI MDS 2.0
Time frame: 3 and 6 months after receiving the intervention
Frequency of pain
Measured using the Pain Scale obtained from RAI MDS 2.0
Time frame: 3 and 6 months after receiving the intervention
Plan to share: No
No publications or documents are linked to this record.
Ran from Mar 2017 to primary completion in Dec 2018, 21 months.
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This study is completed, as verified in Jul 2019. You cannot join it, but the record below documents what was studied.
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Memorial University of Newfoundland