Development of a Coordinated, Community-Based Medication Management Model

Status Completed

Clinical Trial Summary

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.

Clinical Trial Description

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. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT02545257
Study type	Interventional
Source	Helsinki University
Contact
Status	Completed
Phase	N/A
Start date	September 2015
Completion date	December 2018

View Details

See also
Status	Clinical Trial	Phase
Completed	`NCT03688542` - Opportunities and Limits to Deprescribing in Nursing Homes:Quality Circle Deprescribing Module	N/A
Withdrawn	`NCT01932632` - Medication Minimization for Long-term Care Residents	N/A
Recruiting	`NCT04615065` - Acutelines: a Large Data-/Biobank of Acute and Emergency Medicine
Active, not recruiting	`NCT04181879` - Appropriate Polypharmacy in Older People in Primary Care	N/A
Not yet recruiting	`NCT03283735` - Deprescribing: a Portrait and Out-comes of the Reduction of Polypharmacy in Portugal	N/A
Completed	`NCT02918058` - Reducing Post-discharge Potentially Inappropriate Medications Among Older Adults	N/A
Enrolling by invitation	`NCT05656560` - Reducing High-Risk Geriatric Polypharmacy Via EHR Nudges R01 Trial	N/A
Completed	`NCT03655405` - Randomised, Controlled Trial of an Individual Deprescribing Intervention for Nursing Homes Residents	N/A
Completed	`NCT04575155` - Development & Pilot of the Technology-Enabled Alliance for Medication Therapy Management	N/A
Withdrawn	`NCT05816967` - Rationalisation of Polypharmacy by the RASP-instrument and Discharge Counselling of Geriatric Inpatients	N/A
Completed	`NCT05616689` - Bundled Hyperpolypharmacy Deprescribing	N/A
Terminated	`NCT04055896` - Team Approach to Polypharmacy Evaluation and Reduction in a Long-Term Care Setting	N/A
Active, not recruiting	`NCT03052192` - Biological Aging, Medication, Malnutrition and Inflammation Among Acutely Ill and Healthy Elderly.
Completed	`NCT02866799` - Multi-PAP: Improving Prescription in Primary Care Patients With Multimorbidity and Polypharmacy	N/A
Completed	`NCT01732302` - Educational Intervention to Reduce Drug-related Hospitalizations in Elderly Primary Health Care Patients	N/A
Enrolling by invitation	`NCT05053815` - Pharmacogenomic Testing in a Program of All-inclusive Care for the Elderly (PACE) Setting
Recruiting	`NCT04585191` - Reducing Treatment Risk in Older Adults With Diabetes	N/A
Active, not recruiting	`NCT04120480` - Effectiveness of PGx Testing	N/A
Recruiting	`NCT05609981` - Optimising Medication With Focus on Deprescribing in Frail Older People With Multidose Drug Dispensing Systems	N/A
Recruiting	`NCT05501223` - Physician-initiated Medication Review in a Type 2 Diabetes Outpatient Clinic	N/A

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Development of a Coordinated, Community-Based Medication Management Model for Home-Dwelling Aged in Primary Care

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms