Deprescribing in nursing homes: Protocol for nested, randomised controlled hybrid trials of deprescribing interventions.

Details

Serval ID
serval:BIB_42EF14B830B5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Deprescribing in nursing homes: Protocol for nested, randomised controlled hybrid trials of deprescribing interventions.
Journal
Research in social & administrative pharmacy
Author(s)
Cateau D., Ballabeni P., Mena S., Bugnon O., Niquille A.
ISSN
1934-8150 (Electronic)
ISSN-L
1551-7411
Publication state
Published
Issued date
05/2020
Peer-reviewed
Oui
Number
20
Pages
S1551-7411
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Polypharmacy and the use of potentially inappropriate medication (PIMs) are frequent among nursing home (NH) residents, and are associated with adverse health outcomes like falls, hospitalisation and death. Deprescribing has been proposed as a way to curtail both problems; however, the best way to implement deprescribing and its real impact are still unclear. This article describes nested trials of two consecutive deprescribing interventions, the first at the NH level, and the second at the resident level.
The first intervention (QC-DeMo) will be a deprescribing module to be carried out in existing interprofessional quality circles in NHs, with the goal to develop a NH-wide deprescribing consensus. Its effects will be evaluated on the use of PIMs and on patient safety outcomes such as death, hospitalisation and falls. All NHs in the cantons of Vaud and Fribourg with an integrated pharmacy service will be eligible. The second intervention (IDeI), at the resident level, will be a deprescribing-focused medication review, resulting in the implementation of a deprescribing plan. Its effects will be evaluated on the use of PIMs and chronic medications, and on quality of life. This second trial will take place in the NHs allocated to the intervention group of the first trial. All residents of these NHs over 65 years old, living in the NH for at least 4 months, and taking 5 or more medications will be eligible to participate. Both trials will be hybrid effectiveness and implementation trials, aiming to understand the implementation process for the interventions, and to identify barriers and facilitators.
Both trials were approved by the relevant ethics committee, registered on ClinicalTrials.gov (QC-DeMo: NCT03688542; IDeI: NCT03655405), and funded by the Swiss National Fund for Scientific Research.
Keywords
Deprescriptions, Nursing homes, Patient safety, Pharmaceutical services, Potentially inappropriate medication list
Pubmed
Open Access
Yes
Funding(s)
Swiss National Science Foundation / Programmes
Create date
08/07/2020 11:48
Last modification date
29/07/2020 5:22
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