None listed
Conditions
Brief summary
Use of inappropriate drugs among insititutionalized older people is very common and may lead to unnecessary hospitalizations and impaired quality of life. The aim of this study is to investigate whether training nursing home staff (nurses, consulting physician) reduces the use of inappropriate, anticholinergic and psychotropic drugs among institutionalized older people. We also investigate the effects of intervention on older people's HrQOL, cognition and use and costs of health services, especially hospitalizations. The primary endpoint will be number of inappropriate, anticholinergic and psychotropic drugs and the secondary outcomes will be older people's HrQOL, cognition and use and costs of health services. The wards will be randomized into two groups,and the staff in the intervention wards will receive training concerning the use of drugs in older people, to identify inappropriate, anticholinergic and psychotropic drugs and their harmful effects. The intervenion wards will have an appointed nurse who is responsible to identify harmful drugs among the residents in her wards and to take these problems to the consulting doctor who is responsible to comprehensively take care of the patient. The trial will last for 12 months, the assessment time points will 0,6 and 12 months.
Interventions
The staff in intervention wards will be trained to identify inappropiate drugs, drugs with anticholinergic properties and psychotropic drugs in their patients as well as potentially dangerous drug-drug interactions. The training for the ward staff will take one day (6 hours). The training will be be on constructive and activating learning methods, the drugs problems will be discussed based on the patient cases in the ward. A responsible nurse will be pointed out in the ward to indentify problem
The staff in intervention wards will be trained to identify inappropiate drugs, drugs with anticholinergic properties and psychotropic drugs in their patients as well as potentially dangerous drug-drug interactions. The training for the ward staff will take one day (6 hours). The training will be be on constructive and activating learning methods, the drugs problems will be discussed based on the patient cases in the ward. A responsible nurse will be pointed out in the ward to indentify problems in medication and to take them to the consulting doctor. The doctor will be responsible for changes in medication. The responsible nurse will get extra training (one session, 6 hours) on medications and their harmful effects. In addition, she will receive a list of inappropriate drugs. She will also receive tutoring for her work with the medications when needed.
Sponsors
Helsinki University Central Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Living permanently in Helsinki nursing home/ assisted living facility - 65 years+ - native Finnish skeaking - uses at least one drug - not at terminal stage (estimated prognosis >6 months) - volunteer, participant or his/her proxy gives an informed consent to participate the study
Exclusion criteria
Terminal stage Has no drugs in regular use
Outcome results
None listed