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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05616689
Other study ID # RDO KPNC 20 - 008
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date October 19, 2020
Est. completion date May 24, 2023

Study information

Verified date December 2023
Source Kaiser Permanente
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Older patients using many prescription drugs (hyperpolypharmacy) may be at increased risk of adverse drug effects. This randomized controlled trial tested the effectiveness and safety of a quality intervention intended to reduce hyperpolypharmacy. The study was set at Kaiser Permanente Northern California, an integrated health system with multiple pre-existing deprescribing workflows. Eligible patients were aged ≥76 years using ≥10 prescription medications. The intervention included physician-pharmacist collaborative drug therapy management, standard-of-care practice recommendations, shared decision-making, and deprescribing protocols administered by telephone over multiple cycles for a maximum of 180 days after allocation. A priori primary effectiveness endpoints included change in the number of medications and in the prevalence of geriatric syndrome from 181-365 days after allocation. Second endpoints included utilization and adverse drug withdrawal effects. Information was obtained from the electronic health record.


Recruitment information / eligibility

Status Completed
Enrollment 2471
Est. completion date May 24, 2023
Est. primary completion date July 29, 2022
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 76 Years and older
Eligibility Inclusion Criteria: - Kaiser Permanente patients - Age =76 years - =10 drugs (excluding topicals) where - drug filled =2 times in the past year and - drug last filled < 180 days ago Exclusion Criteria: - less than 12 months preceding enrollment at Kaiser Permanente - no primary care practitioner assigned - on dialysis - history of heart, liver, lung, breast, or bone marrow transplant - in hospice - under active treatment for cancer during the past 12 months - has received an intervention through the Pharmacy Targeted Deprescribing Program in the preceding year.

Study Design


Related Conditions & MeSH terms


Intervention

Other:
Bundled hyperpolypharmacy
Bundled hyperpolypharmacy playbook to be used by pharmacist, with physician approval, in shared decision making with participant,

Locations

Country Name City State
United States Kaiser Permanente Division of Research Oakland California

Sponsors (1)

Lead Sponsor Collaborator
Kaiser Permanente

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Adverse drug withdrawal effects Change in prevalence of lower respiratory, cardiovascular, gastrointestinal, hyperuricemia, and elevated blood glucose Difference between (days 181-365 after randomization) and (180 days before randomization)
Primary Change in prevalence of geriatric syndrome Change in prevalence for any of the following: Falls (hip fracture, lower leg fracture, osteoporosis with fracture, pathologic fracture, osteonecrosis; gait; repeated falls; syncope; tripping; reduced mobility), Cognition (Somnolence; awareness; dizziness; malaise; Urinary incontinence (Unspecified urinary incontinence; retention of urine, unspecified; functional urinary incontinence; stress incontinence ; other specified urinary incontinence) and Pain (Drug induced headache; joint pain; muscle weakness, rhabdomyolysis, spas; myalgia) Difference between (days 181-365 after randomization) and (180 days before randomization)
Primary Change in number of medications Change in number of dispensed medications recorded in the comprehensive, integrated pharmacy information system Difference between (days 181-365 after randomization) and (180 days before randomization)
Secondary Utilization Change in number of outpatient visits, inpatient visits, and emergency department visits. Difference between (days 181-365 after randomization) and (180 days before randomization)
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