Team Approach to Polypharmacy Reduction to Improve Mobility Long-Term Care

Status Terminated

Clinical Trial Summary

Medication side effects and interactions between medications are very common in older adults and are related to negative health outcomes, including mobility. In this study, the investigators will test a new process aimed at reducing unnecessary medication use and drug side effects in seniors using the best medical evidence and patient preferences for treatment. This study will assess how feasible the implementation of this intervention is within a long-term care facility as well as if it is possible. The study will also assess for any signals of reversal of medications related mobility impairments to reduce medications-related mobility impairment (fatigue, pain, falls) using the intervention. Participants in two long-term care facilities will participate in this study. Measures will include feasibility outcomes regarding the logistics of the intervention as well as patients outcomes (falls, hospitalizations, and medications) collected before and after implementation. Findings will inform the design of a randomized controlled trial to test the effect of this intervention on health outcomes.

Clinical Trial Description

There are substantial associations between polypharmacy and reduced function from older adults and this is likely to be important in frail older adults both in long term care and in the community. The reversibility of drug-induced mobility impairment is unclear therefore the investigators plan to investigate signals of any impact of reducing polypharmacy on mobility. The investigators chose the long-term care setting given the presence of complete medication administration records and this patient population's high prevalence of polypharmacy and risk of adverse drug events. TAPERMD is an electronic tool for systematic medication reduction that incorporates patient priorities, electronic screening for potentially harmful medicines, supporting evidence tools and a monitoring pathway to support medication reduction. This study will examine the feasibility of this tool in a long-term care setting as well as examine. Participants in two long-term care facilities will participate in this study. Measures will include feasibility outcomes regarding the logistics of the intervention as well as patients outcomes (falls, hospitalizations, and medications) collected before and after implementation. Findings will inform a randomized controlled trial to measure the effect of this intervention on health outcomes. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT03202264
Study type	Observational
Source	McMaster University
Contact
Status	Terminated
Phase
Start date	July 1, 2017
Completion date	November 13, 2019

View Details

See also
Status	Clinical Trial	Phase
Completed	`NCT03688542` - Opportunities and Limits to Deprescribing in Nursing Homes:Quality Circle Deprescribing Module	N/A
Completed	`NCT02545257` - Development of a Coordinated, Community-Based Medication Management Model for Home-Dwelling Aged in Primary Care	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
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
Active, not 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