polypharmacy, polyfarmacie elderly, ouderen pharmacist, apotheker general practitioner, huisarts
Conditions
Interventions
Intervention. The integral medication control and monitoring system exists of an integrated approach:
1. The pharmacist selects patients aged 60 years or older who have polypharmacy
2. Patients are visited by the nurse practitioner, who makes an inventory of all medication currently used by the patient as well as length and weight of the patient, and blood pressure during a home
3. Information from the electronic patient record (EPR) in general practice is added (medication according to the GP, medical problem list (diagnoses), recent correspondence from other medical special
4. If lab results are incomplete or when they are older then 1 year, additional blood tests (kidney, liver enzymes, TSH, glucose, cholesterol, electrolytes and others if relevant for the condition of
5. Based on this comprehensive set of information the pharmacist and general practitioner define an integral medication advice (if appropriate including a reconstruction scheme and fitting in the pati
6. This medical advice is reached by following the next six steps:
A. Rubricating medication prescribed in the following seven groups
a. Cardiovascular
b. Diabetes mellitus
c. Tractus digestivus
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Sponsors
Maastricht University
School for Public Health and Primary Care (Caphri)
Department of General Practice
Eligibility
Inclusion criteria
Inclusion criteria: 1. Patients older than 60 years with use of five ore more different prescription drugs; 2. Good knowledge of the Dutch language; 3. Informed consent.
Exclusion criteria
Exclusion criteria: 1. Critically ill patients with a life expectancy less than one year; 2. Patients who are incompetent to act for themselves.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Patient physical and mental health ] outcomes (using data from the MDS); 2. Patient psychosocial outcomes, including quality of life outcomes, well-being and measures of disability of functional status (using data from the MDS). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Measures of patient medication adherence, utilization of health services (including the number of prescriptions, number of hospitalizations); 2. Acceptability and feasibility of the intervention according to patients, GPs, nurse practitioners and pharmacists (barriers and facilitators); 3. Costs of medication prescriptions; 4. Medication compliance bij measering pill- count. | — |
Contacts
Public ContactDonna Bosch-Lenders
Postbus 616
Outcome results
None listed