Effect of Training and Structured Medication Review on Medication Appropriateness in Nursing Home Residents and on Cooperation Between Health Care Professionals: the InTherAKT Study Protocol

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2017 Jan 20

PMID 28100176

Citations 6

Authors

Angelika Mahlknecht

Nadja Nestler

Ulrike Bauer

Nadine Schussler

Jochen Schuler

Sebastian Scharer

Ralf Becker

Isabel Waltering

Georg Hempel

Oliver Schwalbe

Maria Flamm

Jurgen Osterbrink

Affiliations

Soon will be listed here.

Abstract

Background: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes.

Methods/design: The trial is designed as single-arm study. It involves 300 nursing home residents aged ≥ 65 years and the members of the different professional groups practising in nursing home care (15-20 general practitioners, nurses, pharmacists). The intervention consists of interprofessional education on safe medication use in geriatric patients, and a systematic interprofessional therapy check (recording, reviewing and adapting the medication of the participating residents by means of a specific online platform). The intervention period is divided into two phases; total project period is 3 years. Primary outcome measure is the change in medication appropriateness according to the Medication Appropriateness Index. Secondary outcomes are cognitive performance, occurrence of delirium, agitation, tendency of falls, total number of drugs, number of potentially dangerous drug-drug interactions and appropriateness of recorded analgesic therapy regimens according to the Medication Appropriateness Index. Data are collected at t (before the start of the intervention), t (after the first intervention period) and t (after the second intervention period). Cooperation and communication between the professional groups are investigated twice by qualitative interviews.

Discussion: The project aims to establish a structured system for monitoring of drug therapy in nursing home residents. The newly developed online platform is designed to systematize and to improve the communication between the professional groups and, thus, to enhance quality and safety of drug therapy. Limitations of the study are the lack of a control group and the non-randomly recruited study sample.

Trial Registration: DRKS Data Management, DRKS-ID: DRKS00007900.

Citing Articles

Impact of medication review via tele-expertise on unplanned hospitalizations at 3 months of nursing homes patients (TEM-EHPAD): study protocol for a randomized controlled trial.

Correard F, Montaleytang M, Costa M, Astolfi M, Baumstarck K, Loubiere S BMC Geriatr. 2020; 20(1):147.

PMID: 32312242 PMC: 7169005. DOI: 10.1186/s12877-020-01546-3.

Impact of training and structured medication review on medication appropriateness and patient-related outcomes in nursing homes: results from the interventional study InTherAKT.

Mahlknecht A, Krisch L, Nestler N, Bauer U, Letz N, Zenz D BMC Geriatr. 2019; 19(1):257.

PMID: 31533630 PMC: 6749664. DOI: 10.1186/s12877-019-1263-3.

Multidisciplinary intervention to improve medication safety in nursing home residents: protocol of a cluster randomised controlled trial (HIOPP-3-iTBX study).

Krause O, Wiese B, Doyle I, Kirsch C, Thurmann P, Wilm S BMC Geriatr. 2019; 19(1):24.

PMID: 30683060 PMC: 6347799. DOI: 10.1186/s12877-019-1027-0.

Approaches to Deprescribing Psychotropic Medications for Changed Behaviours in Long-Term Care Residents Living with Dementia.

Harrison S, Cations M, Jessop T, Hilmer S, Sawan M, Brodaty H Drugs Aging. 2018; 36(2):125-136.

PMID: 30535930 DOI: 10.1007/s40266-018-0623-6.

Nurse-led medicines' monitoring in care homes study protocol: a process evaluation of the impact and sustainability of the adverse drug reaction (ADRe) profile for mental health medicines.

Jordan S, Banner T, Gabe-Walters M, Mikhail J, Round J, Snelgrove S BMJ Open. 2018; 8(9):e023377.

PMID: 30269073 PMC: 6169755. DOI: 10.1136/bmjopen-2018-023377.

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