To investigate whether a clinical medication review, focused on the perceived hindering complaints and personal wishes of the patients regarding their medication, improves health-related quality of life of older persons aged 70 years or older using…
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
alle aandoeningen waarbij farmacotherapie wordt ingezet
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
1. Health-related quality of life (EQ-5D-5L)
2. Number of hindering complaints per patient
Secondary outcome
1. Health care utilization (used for calculating direct medical costs and
non-medical costs)
2. The number of drug changes per patient
3. The number and type of ceased drugs after 3 and 6 months
4. The number and type of added drugs after 3 and 6 months
5. The number and type of goals at baseline
6. Scores on the Goal Attainment Scales (GAS) measured after 3 and 6 months
7. The number and type of drug-related problems (DRPs) per patient
8. Implementation rate of the recommendations associated with the DRPs
Background summary
Polypharmacy is related to the use of inappropriate medication and drug-related
problems (DRPs). Clinical medication reviews are increasingly performed to
identify and reduce these DRPs. Studies have shown effects of medication
reviews on process- and intermediate outcomes, like DRPs medication changes and
cholesterol values. Moreover, studies suggest that medication reviews can
improve pain management or reduce falls. However little effect has been shown
on major clinical outcomes, like morbidity, mortality, hospital admissions or
quality of life.
In particular, quality of life is related to the individual needs of patients
in relation to their health and daily problems. The wish to use less medication
is common among the elderly with polypharmacy. In this context, more and more
research is performed on the topic: "deprescribing" in the elderly. These
studies indicate that it is possible to discontinue (preventive) medication in
the elderly if the benefits of a drug (e.g. long-term effect) no longer
outweigh the disadvantages (e.g. experienced adverse events). Older people
often have symptoms, which are not life-threatening, but can be hindering. Such
hindering complaints can often be easily treated, by changing a drug for
example. In this study, we will focus on the elderly with polypharmacy who
experience health problems which are possibly related to the use of medication.
Thereby, one or more health related goals will be drafted with the patient.
Study objective
To investigate whether a clinical medication review, focused on the perceived
hindering complaints and personal wishes of the patients regarding their
medication, improves health-related quality of life of older persons aged 70
years or older using 7 or more drugs.
Study design
The study is a randomized controlled intervention study.
Control patients are added to a waiting list and will receive the intervention
after 6 months.
Intervention
Patients in the intervention group will directly receive a clinical medication
review at the start of the study. Patients in the waiting list group will
receive usual care and will be provided with a clinical medication review after
6 months.
Study burden and risks
The risk of damage for the subjects participating in this study is low, because
the intervention is already embedded in regular pharmaceutical patient care.
Universiteitsweg 99
Utrecht 3584CG
NL
Universiteitsweg 99
Utrecht 3584CG
NL
Listed location countries
Age
Inclusion criteria
Home-dwelling patients aged 70 years or older, using 7 or more chronic medicines
Exclusion criteria
Persons receiving repeat prescriptions solely from a specialist. (the GP is not the primary caregiver)
Persons with a life expectancy shorter than 6 months.
Persons who had a hospital admission < 1 month before the start of the trial
Persons who already received a medication review in the past 12 months
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
In other registers
| Register | ID |
|---|---|
| CCMO | NL54715.041.15 |
| OMON | NL-OMON27932 |