Optimizing Prescribing of Antipsychotics in Long-Term Care

NCT03557593 | Completed

• 1 other identifier: 6017760
• Study Type: interventional
• Target: N/A
• Locations: 0 countries
• Sites: N/A

Brief Summary

Inappropriate antipsychotic prescribing is a key quality indicator by which clinical outcomes might be monitored and improved in LTC. A multi component intervention to reduce inappropriate antipsychotic prescribing was evaluated in ten Canadian long-term care facilities.

Conditions

Dementia

Keywords

Antipsychotic; Nursing home; Long-term care

Outcome Measures

Primary Outcomes (1)

• Percentage of long-term care residents receiving any antipsychotic without a diagnosis of psychosis

  The proportion of long-term care residents receiving any antipsychotic without a diagnosis of psychosis is a quality indicator is used by the Canadian Institute for Health Information to determine potentially inappropriate antipsychotic use. The quality indicator is calculated using information routinely collected on Resident Assessment Index-Minimum Dataset (RAI-MDS) assessments by determining the number of individuals who received antipsychotics on one of more days in the 7 days preceding index (RAI-MDS item O4a ≥ 1). Individuals with schizophrenia, Huntington's disease, hallucinations, delusions, those with a limited life expectancy and those currently receiving palliative care are excluded from the numerator and denominator of this indicator.

  12-months

Secondary Outcomes (5)

• Worsening of behavioral symptoms

  12-months

• Use of physical restraints

  12-months

• Depression: Proportion of residents whose mood from symptoms of depression worsened

  12-months

• Falls: Proportion of residents experiencing a fall in the 30 day

  12-months

• Pain: Proportion of residents who had pain

  12-months

Interventions

Educational OTHER

Multi component educational intervention in long-term care

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosis of dementia
• Receiving an antipsychotic medication without a diagnosis of psychosis

You may not qualify if:

• Diagnoses of schizophrenia, Huntington's disease
• Presence of active hallucinations and/or delusions
• Individuals at end of live or receiving palliative care

Sponsors & Collaborators

• Queen's University: lead
• Canadian Consortium on Neurodegeneration in Aging: collaborator
• Canadian Frailty Network: collaborator

MeSH Terms

Conditions

Dementia

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Associate Professor, Dept. of Psychiatry, Queen's University

Model Details: Randomized, stepped-wedge cluster trial.

Study Record Dates

• First Submitted: April 6, 2018
• First Posted: June 15, 2018
• Study Start: January 1, 2016
• Primary Completion: October 1, 2017
• Study Completion: December 1, 2017
• Last Updated: June 26, 2018

Record last verified: 2018-06

Data Sharing

• IPD Sharing: Will not share