Polypharmacy, antipsychotics, PIM.
Conditions
Interventions
Group 1: Participating nursing home residents in the intervention group receive a medication review by a specially trained pharamacist. The parttaking professions receive a multimodal interprofessiona
Sponsors
Medizinische Hochschule Hannover
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: Nursing homes: size at least 30 residents and nursing home status with a provision contract in accordance with §72 SGB XI. Nursing home residents: at least 65 years old and in long-term residential care. GPs: serving a nursing home participating in the study, willing to provide participants' health data (current diagnoses, laboratory parameters), willing to participate in the intervention if randomised to the intervention group (take note of/check pharmacist's medication review and if necessary adjust presciption), willing to participate in training (peer-education outreach visits). Pharmacists: serving a nursing home participating in the study (i.e. member of staff in a pharmacy which has a provision contract with a participating nursing home), willing to participate in the ATHINA and HIOPP-3 training if randomised to the intervention group.
Exclusion criteria
Exclusion criteria: Nursing home: specialised homes/wards (psychiatric nursing home, nursing homes for patients requiring mechanical ventilation or with addictions), patients in short-term care. Nursing home residents: residents without written consent, residents with a life expectancy less than 6 months based on GP assessment. GPs: currently participating in a so called polymedication contract (HzV) with the AOK (a German statutory health insurance Company) and/or take part in a current study about medication of nursing home rsidents, GPs who concurrently serve intervention and controll homes, GPs without written consent. Pharmacists: without willingness to participate in the ATHINA and HIOPP-3 trainings, pharmacists who concurrently serve intervention and control group nursing homes, pharmacists without written consent.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The rate of nursing home residents with PIM and/or two antipsychotic drugs. This will be measured by a study Nurse at T0 and T1 using the nursing home documentation or medication documentation. | — |
Secondary
| Measure | Time frame |
|---|---|
| Number of active pharmaceutical components, PIM, neuroleptics, falls, hospitalisations and their duration, emergency medical services, unplanned/unscheduled GP contacts, quality of life, cognition, healtheconomic outcomes, health care utilisation and patient care based on routine health data. Information on sociodemographic background, social contacts, general health status, quality of life, affectivity and pain is measured as part of a questionnaire by a study nurse. If the NHR has given seperate consent, the nursing home will administer a memory test (Mini Mental State Test). All other parameters are collected by the study Nurse via the nursing home documentation. If a NHR cannot be interviewed in person, relatives, nursing staff or nursing documentation will be used as data sources. All secondary endpoints will be collected twice, once at T0 and once at T1. | — |
Countries
Germany
Contacts
Public ContactClaudia Kirsch
Medizinische Hochschule Hannover, Institut für Allgemeinmedizin, OE 5440,
Outcome results
None listed