Fall in Nursing Home, Medication Therapy Management
Conditions
Brief summary
This is a multi-centre study in Singapore nursing homes, investigating the factors that affecting deprescribing, and if a team-care based deprescribing standard practice gives superior health and pharmacoeconomic outcomes over current medication review practice.
Interventions
OTHERTeam-care deprescribing with deprescribing guide
Beers criteria 2015, STOPP criteria 2014, drug interaction
Sponsors
Monash University
National Healthcare Group, Singapore
Tan Tock Seng Hospital
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
For interview questionnaire: Inclusion criteria are: 1. Accepted informed consent, 2. The healthcare professional is practicing in the involved nursing homes.
Exclusion criteria
are: 1\) Decline/unable to provide consent. For team-care deprescribing study: Inclusion criteria are: 1. Accepted informed consent (unless cognitive-impaired, with no or un-contactable next-of-kin), 2. Adult aged 65 years and above, 3. Currently on five or more medications.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change from baseline in Fall Risk Assessment Tool (FRAT) score | Change from baseline in FRAT score at 3 months |
| Change from baseline in fall rate | Change from baseline in fall rate at 3 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in mean medication cost per subject | Change from baseline in mean medication cost at 3 months | — |
| Factors affecting deprescribing | 0 month | Interview questionnaire |
| Change from baseline in percentage of drug-related problems (DRPs) | Change from baseline in percentage of DRPs at 3 months | Medication review form (Hepler/Strand DRP classification system) |
| Change from baseline in deprescribing intervention acceptance rate | Change from baseline in deprescribing intervention acceptance rate at 3 months | — |
| Change from baseline in mean number of medications per subject | Change from baseline in mean number of medications per subject at 3 months | — |
Countries
Singapore
Outcome results
None listed