GeriMedRisk®, a telemedicine geriatric pharmacology consultation service to address adverse drug events in long-term care

GeriMedRisk®, a telemedicine geriatric pharmacology consultation service to address adverse drug events in long-term care: a cluster randomized feasibility trial protocol

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN17219647

Enrollment

Registered

2017-03-27

Start date

2017-04-01

Completion date

Unknown

Last updated

2026-06-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Geriatric adverse drug events Other

Interventions

This study is a stepped wedge cluster randomized controlled trial (simple randomization with a computer generated sequence). The intervention is access to GeriMedRisk®, a pioneering, interdisciplinary

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: All physicians, pharmacists and nurse practitioners who provide patient care in a participating LTC site (a convenience sample of LTC homes in the Waterloo-Wellington region)

Exclusion criteria

Exclusion criteria: Does not meet inclusion criteria

Design outcomes

Primary

Measure	Time frame
The primary outcome measures of this feasibility study will scrutinize the logistics of the GeriMedRisk® intervention and study design: 1. Number of clinicians who use GeriMedRisk® (GeriMedRisk® (GMR) database) (Timing: monthly after commencement of access to GeriMedRisk): 1.1. MD 1.2. Pharmacist 1.3. NP 1.4. Through TAPERMD 2. Number of clinicians who decline GeriMedRisk® (Roster of LTC clinicians, GMR database) (Timing: monthly after commencement of access to GeriMedRisk): 2.1. MD 2.2. Pharmacist 2.3. NP 3. Number of patients/Substitute Decision Makers who decline GeriMedRisk®. Patients and their caregivers will have the opportunity to opt out of GeriMedRisk®. These will be individually reported and collected real time. (Timing: monthly after commencement of access to GeriMedRisk) 4. Number of consults (GMR database, OTN) (Timing: monthly after commencement of access to GeriMedRisk): 4.1. Telephone 4.2. Telemedicine: OTN e-consult 4.3. Through TAPERMD 4.3.1. Telephone 4.3.2. Telemedicine: OTN e-consult 5. Wait times: (telephone records, OTN) (Timing: monthly after commencement of access to GeriMedRisk): 5.1. Telephone 5.1.1. Time from the conclusion of the initial automated message to: 5.1.1.1. When GeriMedRisk® team member picks up the phone (telephone records) 5.1.1.2. When Caller hangs up (telephone records) 5.1.1.2.1. To use e-consult (telephone records, OTN) 5.1.1.2.2. To leave a call back number (telephone records) 5.1.1.2.3. No further contact in the next 7 days (dropped call) (telephone records, OTN) 5.2. E-consult: Time from e-consult request received to (OTN): 5.2.1. GeriMedRisk® team member commences consult 5.2.2. GeriMedRisk® team member provides e-consult opinion 6. Length of calls (telephone records, GMR database) (Timing: monthly after commencement of access to GeriMedRisk): 6.1. Initial consult with pharmacist/RN 6.2. Initial consult with physician 6.3. Follow up with pharmacist/RN 6.4. Follow up with physician 6.4.1. Geriatrician/clinical phar	—

Measure

Time frame

The primary outcome measures of this feasibility study will scrutinize the logistics of the GeriMedRisk® intervention and study design: 1. Number of clinicians who use GeriMedRisk® (GeriMedRisk® (GMR) database) (Timing: monthly after commencement of access to GeriMedRisk): 1.1. MD 1.2. Pharmacist 1.3. NP 1.4. Through TAPERMD 2. Number of clinicians who decline GeriMedRisk® (Roster of LTC clinicians, GMR database) (Timing: monthly after commencement of access to GeriMedRisk): 2.1. MD 2.2. Pharmacist 2.3. NP 3. Number of patients/Substitute Decision Makers who decline GeriMedRisk®. Patients and their caregivers will have the opportunity to opt out of GeriMedRisk®. These will be individually reported and collected real time. (Timing: monthly after commencement of access to GeriMedRisk) 4. Number of consults (GMR database, OTN) (Timing: monthly after commencement of access to GeriMedRisk): 4.1. Telephone 4.2. Telemedicine: OTN e-consult 4.3. Through TAPERMD 4.3.1. Telephone 4.3.2. Telemedicine: OTN e-consult 5. Wait times: (telephone records, OTN) (Timing: monthly after commencement of access to GeriMedRisk): 5.1. Telephone 5.1.1. Time from the conclusion of the initial automated message to: 5.1.1.1. When GeriMedRisk® team member picks up the phone (telephone records) 5.1.1.2. When Caller hangs up (telephone records) 5.1.1.2.1. To use e-consult (telephone records, OTN) 5.1.1.2.2. To leave a call back number (telephone records) 5.1.1.2.3. No further contact in the next 7 days (dropped call) (telephone records, OTN) 5.2. E-consult: Time from e-consult request received to (OTN): 5.2.1. GeriMedRisk® team member commences consult 5.2.2. GeriMedRisk® team member provides e-consult opinion 6. Length of calls (telephone records, GMR database) (Timing: monthly after commencement of access to GeriMedRisk): 6.1. Initial consult with pharmacist/RN 6.2. Initial consult with physician 6.3. Follow up with pharmacist/RN 6.4. Follow up with physician 6.4.1. Geriatrician/clinical phar

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Secondary

Measure	Time frame
Secondary outcomes include falls, hospital visits and medications. Completeness of secondary outcome data (RAI-MDS LTC electronic medical record). This data is regularly collected with the Minimum Data Set, as mandated by the Ministry of Health and Long-Term Care (Timing: 1 year lookback period defined as -365 to date of intervention, and following the commencement of access to GeriMedRisk, monthly) 1. Falls: 1.1. Monthly rate for entire LTC home 1.2. % of injurious falls (defined as requiring physician services, Emergency Department visit or hospitalization) 2. Emergency Hospital visits (exclude hospitalization recommended for supervised deprescription, or elective procedures): 2.1. For patients with a GeriMedRisk® consultation: Time to ED visit (defined as hours from pt consult to ED visit) (GMR database) 3. Medications: 3.1. Prevalence of potentially inappropriate medications 3.1.1. Dose reduction: 3.1.1.1. GeriMedRisk® patients (defined through TAPERMD; captured by GeriMedRisk® clinical database, pharmacy records) 3.1.1.2. All patients in the LTC site (RAI MDS 2.0, pharmacy records) 3.2. Prevalence of psychotropics per LTC site (defined as an sedative hypnotic, antidepressant, antianxiolytic, antipsychotic, Lithium) or antiseizure medication (without a diagnosed seizure disorder) (RAI MDS 2.0, LTC pharmacy records) 3.3. Prevalence of patients receiving opioids (LTC pharmacy records)	—

Measure

Time frame

Secondary outcomes include falls, hospital visits and medications. Completeness of secondary outcome data (RAI-MDS LTC electronic medical record). This data is regularly collected with the Minimum Data Set, as mandated by the Ministry of Health and Long-Term Care (Timing: 1 year lookback period defined as -365 to date of intervention, and following the commencement of access to GeriMedRisk, monthly) 1. Falls: 1.1. Monthly rate for entire LTC home 1.2. % of injurious falls (defined as requiring physician services, Emergency Department visit or hospitalization) 2. Emergency Hospital visits (exclude hospitalization recommended for supervised deprescription, or elective procedures): 2.1. For patients with a GeriMedRisk® consultation: Time to ED visit (defined as hours from pt consult to ED visit) (GMR database) 3. Medications: 3.1. Prevalence of potentially inappropriate medications 3.1.1. Dose reduction: 3.1.1.1. GeriMedRisk® patients (defined through TAPERMD; captured by GeriMedRisk® clinical database, pharmacy records) 3.1.1.2. All patients in the LTC site (RAI MDS 2.0, pharmacy records) 3.2. Prevalence of psychotropics per LTC site (defined as an sedative hypnotic, antidepressant, antianxiolytic, antipsychotic, Lithium) or antiseizure medication (without a diagnosed seizure disorder) (RAI MDS 2.0, LTC pharmacy records) 3.3. Prevalence of patients receiving opioids (LTC pharmacy records)

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Countries

Canada

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Jun 21, 2026