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The Adverse Drug Reaction (ADRe) Profile for Polypharmacy — ADRe-p  

Polypharmacy Clinical Trial

Official title:
Polypharmacy and Adverse Drug Reactions: Nurse-led Intervention to Minimise Adverse Drug Reactions for Older Adults in Care Homes: a Quality Improvement Process Intervention

Clinical Trial Summary

Polypharmacy, the use of multiple or inappropriate medications, has the potential to harm older adults by causing cognitive impairment, falls, and hospitalisations. The nurse-led intervention (The ADRe Profile) to review mental health medicines has demonstrated improved care quality by: identifying serious adverse drug reactions (ADRs); reducing prescription of mental health medicines; reducing the prevalence of pain and nausea; and, increasing non-urgent national health service (NHS) contacts. The investigators will develop ADRe to encompass medicines commonly prescribed in primary care and evaluate intervention implementation in care homes in Aneurin Bevan University Health Board.

Clinical Trial Description

The investigators will introduce medicines' monitoring using the PADRe Profile into up to 7 care homes, each with up to 26 residents prescribed >4 medicines (estimated ~90% residents). Each home will identify a nurse lead and a deputy. Nurses will be asked to administer the PADRe Profile with all patients prescribed >4 medicines. Barriers, facilitators, and feasibility of the Profile will be explored. This will identify how, in which contexts medicines' monitoring can be integrated into routine care, relate the Profile to improved processes and outcomes of care, and inform implementation strategies (see logic model in cited papers). Data collection: - Record review before and after each of 3 administrations of the intervention to identify clinical and prescription changes. Narrative accounts of problems causing moderate or severe harm will be prepared. - Serial interviews and debriefs with nurses: three per nurse. - Stakeholder interviews with patients, participating pharmacists and prescribers for an overview of implementation. ;

Study Design

Related Conditions & MeSH terms

  • Drug-Related Side Effects and Adverse Reactions
  • Polypharmacy
Clinical Trial Details
NCT number NCT03955133
Study type Interventional
Source Swansea University
Contact
Status Completed
Phase N/A
Start date December 18, 2018
Completion date December 31, 2020
View Details
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