Skip to main content
OpenTrials
Completed

NCT Number: NCT01732302

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

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.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Polypharmacy Adverse Drug Reaction Chemically-Induced Disorders Drug-Related Side Effects and Adverse Reactions

Age range

65 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

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

Huddinge, 14183, Sweden

About this study

Inappropriate medication in the elderly patient leads to substantial morbidity, possibly causing up to 20% of hospitalizations in this patient group (1). To improve prescribing and thus reduce undesired drug effects is a great challenge for doctors and nurses in primary health care.

Performance of drug utilization reviews is recommended in order to reduce the negative impact of inappropriate prescribing in the elderly. However, scientific evidence on their efficacy is lacking, especially regarding patient-related health outcomes (2,3). Most studies are carried out in inpatient care, making it difficult to draw conclusions regarding primary health care (2). Moreover, studies in this scientific field diverge regarding the content and structure of drug utilization reviews, which implies that comparison between studies becomes challenging, if not impossible.

This trial aims at educating health care providers in how to perform drug utilization reviews, and to help them implement theory into practice.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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

Exclusion criteria

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

Treatment and study plan

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.

Primary outcomes

  1. Composite outcome: Unplanned hospitalisation or emergency department visit

    Time frame: 9 months

Secondary outcomes

  1. Unplanned hospitalisation

    Time frame: 9 months

  2. Emergency department visit

    Time frame: 9 months

  3. Length of hospital stay

    Time frame: 9 months

  4. All cause mortality

    Time frame: 9 months

  5. Number of drug utilization reviews

    Time frame: 9 months

  6. Number of patients with polypharmacy

    Time frame: 9 months

    polypharmacy: 5-9 drugs/patient excessive polypharmacy: 10 and more drugs/patient

  7. Inappropriate drug use according to national guidelines

    Time frame: 9 months

    see link

  8. Number of patients with contraindicated drugs regarding renal function

    Time frame: 9 months

  9. Number of drugs with inappropriate drug dose regarding renal function

    Time frame: 9 months

  10. Number of drug interactions

    Time frame: 9 months

Sponsors and collaborators

Lead sponsor

Karolinska Institutet

Other

Collaborators

  • Region Stockholm

Registry information

Official study title

Educational Intervention to Reduce Drug-related Hospitalizations and Visits in Emergency Departments in Elderly Primary Health Care Patients - a Cluster-randomized Controlled Trial

Important dates

Study start
2012
Primary completion
2013
Study completion
2013
First posted
Nov 22, 2012
Registry last updated
Oct 21, 2013

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.