An Intervention Study to Reduce the Use and Impact of Potentially Inappropriate Medications Among Older Adults

University Institute of Geriatrics of Montreal (IUGM)

Status and phase: Terminated; Phase 4

Conditions: Polypharmacy; Insomnia; Anxiety; Incontinence

Treatments: Behavioral: knowledge transfer tool

Study type: Interventional

Funder types: Other

Identifiers

NCT01148186

CIHR-2009MOP-201314-KTE

Details and patient eligibility

About

An educational intervention targeting community-dwelling older adults will lead to a reduction in potentially inappropriate prescriptions (e.g. benzodiazepines, oxybutynin).

Cessation of potentially inappropriate medications (e.g. benzodiazepines, oxybutynin)will lead to improved cognitive outcomes in older adults.

Full description

This study tests the effectiveness of a knowledge transfer tool for empowering patients to engage in collaborative discontinuation of potentially inappropriate medication with their pharmacist and/or physician

Enrollment: 300 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 65 year old human adults
• who fill a prescription for at least 5 medications
• community dwelling
• chronic use (3 months or longer) of at least one potentially inappropriate medication (e.g. benzodiazepine, oxybutynin)

Exclusion criteria

• patients with severe mental illness, dementia and epilepsy
• concomitant consumption of any other antipsychotic medication (including lithium, olanzapine, clozapine, quetiapine, risperidone, haloperidol etc.)
• concomitant consumption of any antiepileptic (including carbamazepine, valproate, gabapentin, lamotrigine, topiramate, oxcarbazepine etc.)
• concomitant consumption of a cholinesterase inhibitor or memantine

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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300 participants in 2 patient groups

Educational intervention

Experimental group

Description:

Administration of an educational intervention to inform patients of the risks and safe alternatives to their current potentially inappropriate medication. The textual content of this knowledge transfer tool will be divided into three parts: a) presentation of the evidence-based risks associated with the targeted potentially inappropriate medication (e.g. benzodiazepines); b) presentation of evidence-based equally or more effective therapeutic substitutes for the medical condition (e.g. insomnia and anxiety); and c) presentation of evidence based tapering recommendations where applicable.

Treatment:

Behavioral: knowledge transfer tool

Wait-list group

No Intervention group