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

BMC Geriatrics

Study Protocol

Oliver Schwalbe¹  Ralf Becker²  Georg Hempel³  Isabel Waltering³  Jochen Schuler⁴  Maria Flamm⁴  Angelika Mahlknecht⁴  Sebastian Scharer⁴  Nadja Nestler⁵  Nadine Schüßler⁵  Jürgen Osterbrink⁵  Ulrike Bauer⁵ 

[1] Apothekerkammer Westfalen-Lippe/Chamber of Pharmacists Westphalia-Lippe, Bismarckallee 25, 48151, Muenster, Germany;Hausärzteverbund Münster/Association of general practitioners of Muenster, Metzer Strasse 59, 48151, Muenster, Germany;Institut für Pharmazeutische und Medizinische Chemie der Westfälischen Wilhelms-Universität Münster/Institute of Pharmaceutic and Medical Chemistry of the Westfaelische Wilhelms-University, Corrensstraße 48, 48149, Muenster, Germany;Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria;Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria;

关键词: Medication review;    Medication safety;    Safety of drug therapy;    Nursing home care;    Long-term treatment;    Medication appropriateness in nursing homes;    Interprofessional;   

DOI  :  10.1186/s12877-017-0418-3

 received in 2016-01-23, accepted in 2017-01-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPharmacotherapy 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/DesignThe 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 t0 (before the start of the intervention), t1 (after the first intervention period) and t2 (after the second intervention period). Cooperation and communication between the professional groups are investigated twice by qualitative interviews.DiscussionThe 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 registrationDRKS Data Management, DRKS-ID: DRKS00007900

【 授权许可】

CC BY   
© The Author(s). 2017