Educational Intervention to Reduce Drug-related Hospitalizations in Elderly Primary Health Care Patients

NCT01732302 | Completed

• 1 other identifier: 2012 1266-31
• Study Type: interventional
• Target: 69
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine whether an educational intervention given towards health care providers working in primary health care centers can reduce inappropriate prescribing in the elderly patient and thus reduce number and length of drug-related hospitalizations as well as number of emergency department visits in this patient group.

Conditions

Polypharmacy; Adverse Drug Reaction

Keywords

Drug Utilization Review; Aged; Aged, 80 and over; Primary Health Care

Outcome Measures

Primary Outcomes (1)

• Composite outcome: Unplanned hospitalisation or emergency department visit

  9 months

Secondary Outcomes (10)

• Unplanned hospitalisation

  9 months

• Emergency department visit

  9 months

• Length of hospital stay

  9 months

• All cause mortality

  9 months

• Number of drug utilization reviews

  9 months

Study Arms (2)

Educational intervention

EXPERIMENTAL

Primary health care centers (PHCC) in the intervention group will be visited twice by a pharmacist within a period of three months. At the first visit, an educational intervention will focus on two properties: on the one hand, feed-back of actual patient data of the PHCC illustrating the primary-health-care-specific characteristics of inappropriate prescribing in the elderly patient will be given. Education of relevant subjects will be given in relation to detected problems. On the other hand, a clinical routine regarding the performance of drug utilization reviews will be developed in cooperation with the health care providers. At the second visit 3 months later, the developed concept will be critically reviewed and eventually developed further.

Other: Educational intervention

Delayed educational intervention

NO INTERVENTION

Primary health care centers in the delayed intervention group will receive the same intervention as described above with 9 months delay.

Interventions

Educational intervention OTHER

Primary health care centers (PHCC) in the intervention group will be visited twice by a pharmacist within a period of three months. At the first visit, an educational intervention will focus on two properties: on the one hand, feed-back of actual patient data of the PHCC illustrating the primary-health-care-specific characteristics of inappropriate prescribing in the elderly patient will be given. Education of relevant subjects will be given in relation to detected problems. On the other hand, a clinical routine regarding the performance of drug utilization reviews will be developed in cooperation with the health care providers. At the second visit 3 months later, the developed concept will be critically reviewed and eventually developed further.

Educational intervention

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• primary health care center in Stockholm County
• authorized by Stockholm County Council since at least 3 years
• at least 5% of patients attributed to primary health care center are 65 years and older
• primary health care center takes care of at least 10 home care patients

You may not qualify if:

• less than 3000 patients listed in primary health care center
• primary health care centers where researchers carrying out the present study work

Sponsors & Collaborators

• Karolinska Institutet: lead
• Region Stockholm: collaborator

Study Sites (1)

Centre for Family Medicine, Dept of Neurobiology, Care sciences and Society, Karolinska Institutet

Huddinge, 14183, Sweden

Location

Related Publications (3)

• Beijer HJ, de Blaey CJ. Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies. Pharm World Sci. 2002 Apr;24(2):46-54. doi: 10.1023/a:1015570104121.

  PMID: 12061133 BACKGROUND

• Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, Hanlon JT. Appropriate prescribing in elderly people: how well can it be measured and optimised? Lancet. 2007 Jul 14;370(9582):173-184. doi: 10.1016/S0140-6736(07)61091-5.

  PMID: 17630041 BACKGROUND

• Stewart S, Pearson S, Luke CG, Horowitz JD. Effects of home-based intervention on unplanned readmissions and out-of-hospital deaths. J Am Geriatr Soc. 1998 Feb;46(2):174-80. doi: 10.1111/j.1532-5415.1998.tb02535.x.

  PMID: 9475445 BACKGROUND

MeSH Terms

Conditions

Drug-Related Side Effects and Adverse Reactions

Interventions

Early Intervention, Educational

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders

Intervention Hierarchy (Ancestors)

Child Health Services; Community Health Services; Health Services; Health Care Facilities Workforce and Services; Preventive Health Services

Study Officials

• Jan Hasselström, MD, PhD

  Centre for Family Medicine, Dept of Neurobiology, Care sciences and Society, Karolinska Institutet

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: November 19, 2012
• First Posted: November 22, 2012
• Study Start: November 1, 2012
• Primary Completion: September 1, 2013
• Study Completion: September 1, 2013
• Last Updated: October 21, 2013

Record last verified: 2013-10

Locations

SE (1)