OptiMEDs intervention for multidisciplinary medication review in nursing homes to evaluate the appropriateness of prescribing – a pilot study (KCE-17008)

Summary (French or English)

The interest in improving the pharmacotherapy of older adults in nursing homes is growing. We propose a method intending to support the decision of GPs regarding the pharmacotherapy of older adults. To achieve this, we introduce the OptiMEDs intervention: a combination of an electronic decision support tool (for the appraisal of potentially inappropriate medication use, anticholinergic use, or medications that can be de-prescribed in view of limited life expectancy) with focussed nurse observations (guided by a list of potential medication symptoms based on the individual medication chart of the resident), that will serve as the basis for a multidisciplinary medication review with the input of the GP, community pharmacist and nurse. By using the OptiMEDs intervention, we expect to obtain a more appropriate, safer, and more cost-effective pharmacotherapy in nursing home residents (e.g. less medication-related symptoms, less potentially inappropriate prescribing, a better quality of life, less hospitalisations, health care usage, or mortality)

Before investigating the effectiveness of the OptiMEDs intervention in a large pragmatic clinical trial comparing results of the intervention with standard of care, we will performing a pilot study in 3 nursing homes aiming to study the feasibility and acceptability of all components included in OptiMEDs.

Trial Description
Title

Pilot study of the OptiMEDs intervention: a complex intervention for multidisciplinary medication review (including nurses, pharmacists, and physicians) in nursing homes, with ICT-support for the evaluation of the appropriateness of prescribing and for side-effect monitoring KCE-17008

Participants (P)

Residents in nursing homes

Intervention (I)

Formalised medication review involving input from nurses, pharmacist and GP supported by an electronic tool

Control (C)

Medication review as performed according to usual care

Outcome (O)

The feasibility and acceptability of a full study to investigate whether NH residents receiving standardised multidisciplinary medication review (prepared by ICT-support) will use less inappropriate medication four months after the intervention, compared to residents receiving standard care medication review.

Trial Design

Pilot study

Sample Size

estimated 150 residents

Trial duration

11 months

Budget

€ 450,000 including VAT (375,000 excluding VAT)

Status

Open

 

Trial team

Sponsor

Ghent University

Chief Investigator

Prof. Thierry Christiaens

 

Trial coordinator

Maarten Wauters

 

Sites

3 nursing homes (1 control & 2 intervention)

External Partners

Research in Advanced Medical Informatics and Telematcs (RAMIT) vzw

University Antwerpen

Documents
Protocol  
Report

01/06/2020

Publication

 

References

Clinicaltrials.gov: pending

Webpage: 

Funding scheme

Investigator-led workstream 2017