Polypharmacy Clinical Trial
Official title:
Development of a Coordinated, Community-Based Medication Management Model for Home-Dwelling Aged in Primary Care
The objective of this randomized controlled trial is to develop a coordinated, multiprofessional medication management model for home-dwelling aged in primary care and to study the effectiveness of this model. The main hypothesis is that the new model helps to identify aged people having potential risks with their medications and thus allows solving these risks.
The demand for long-term home health care services is increasing due the demographic and
societal developments. Aged people needing home care are increasingly older, have many
chronic diseases and use multiple medicines and thus, are at high risk for drug-related
problems (DRPs). In Finland, national and local healthcare and aged care strategies target to
allowing aged people (over 65 years) living in their own homes as long as possible. This
minimizes the costs of institutionalized care and also targets to add the quality of life of
aged people. New approaches and service models are needed to meet these challenges.
The present study focuses on the development of a coordinated medication management model
which aims to ensure the safe medication practises for home-dwelling aged in primary care. In
the previous parts of this study project were developed a model for comprehensive medication
review process (CMR) and a Drug-Related Problem Risk Assessment Tool. The present study uses
a multistage intervention in which medications are reviewed (prescription review) in a
community pharmacy using the SFINX-database to identify clinically significant drug-drug
interactions and the Salko-database which identifies potentially inappropriate medications
for aged people. In the next stage practical nurses use the Drug-Related Problem Risk
Assessment Tool to identify potential risks. The following stages are based on the results
from the risk assessment tool. Potential options are, e.g.,physician consultation, more
frequent home care visits, counselling given by the community pharmacy or comprehensive
medication review (CMR). The CMR process is only targeted to a limited group of study
participants with clinically significant DRP who probably will benefit from more
comprehensive CMR.
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