Team Approach to Polypharmacy Reduction to Improve Mobility Long-Term Care

NCT03202264 | Terminated Results

• 1 other identifier: TAPER-Mobility
• Study Type: observational
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Medication side effects and interactions between medications are very common in older adults and are related to negative health outcomes, including mobility. In this study, the investigators will test a new process aimed at reducing unnecessary medication use and drug side effects in seniors using the best medical evidence and patient preferences for treatment. This study will assess how feasible the implementation of this intervention is within a long-term care facility as well as if it is possible. The study will also assess for any signals of reversal of medications related mobility impairments to reduce medications-related mobility impairment (fatigue, pain, falls) using the intervention. Participants in two long-term care facilities will participate in this study. Measures will include feasibility outcomes regarding the logistics of the intervention as well as patients outcomes (falls, hospitalizations, and medications) collected before and after implementation. Findings will inform the design of a randomized controlled trial to test the effect of this intervention on health outcomes.

Conditions

Multi-morbidity; Medication Therapy Management; Polypharmacy

Keywords

Polypharmacy; Mobility; Multimorbidity; Drug Discontinuation; Patient Preference; eHealth

Outcome Measures

Primary Outcomes (1)

• Successful Discontinuation (Difference in Mean Number of Medications; Reduction in Dose)

  Difference in mean number of medications; number of medications reduced in dose

  6 months

Secondary Outcomes (20)

• Mobility-related Fatigue

  Baseline, 6 months

• Level of Physical Functioning

  Baseline, 6 Months

• Pain

  Baseline, 6 Months

• Falls

  Baseline, 6 Months

• Sleep

  Baseline, 6 Months

Study Arms (1)

TAPERMD

80 Long term care residents on 5 or more medications aged over 70 from 2 long term care facilities

Other: TAPER

Interventions

TAPER OTHER

The intervention is medication reduction. This arm is comprised of: * Medication reconciliation * Identification of patient priorities for care * Identification of medications that are potentially appropriate for discontinuation/dose reduction * Linked pharmacist/family physician consultations with patient to discuss medication with intention to reduce * Identification of medications for trial of discontinuation/dose reduction (shared decision making) * Pause of medication and clinical monitoring

TAPERMD

Eligibility Criteria

• Age: 70 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adults, 70 years of age or older, residing in 2 long-term care facilities located in the Brampton, Ontario, Canada.

You may qualify if:

• residing in 2 long-term care facilities in Brampton, ON
• on 5 or more medications
• years of age or older
• adequate English language

Sponsors & Collaborators

• McMaster University: lead
• The Labarge Optimal Aging Initiative: collaborator

Study Sites (1)

McMaster University

Hamilton, Ontario, L8P 1H6, Canada

Location

MeSH Terms

Conditions

Patient Preference

Condition Hierarchy (Ancestors)

Patient Satisfaction; Treatment Adherence and Compliance; Health Behavior; Behavior

Results Point of Contact

• Title: Dr. Dee Mangin
• Organization: McMaster University

mangind@mcmaster.ca

905-525-9140

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 23, 2017
• First Posted: June 28, 2017
• Study Start: July 1, 2017
• Primary Completion: November 13, 2019
• Study Completion: November 13, 2019
• Last Updated: September 8, 2021
• Results First Posted: September 8, 2021

Record last verified: 2021-08

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)