Educational Intervention to Reduce Drug-related Hospitalizations in Elderly Primary Health Care Patients

Karolinska Institute

Status: Completed

Conditions: Adverse Drug Reaction; Polypharmacy

Treatments: Other: Educational intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT01732302

2012 1266-31

Details and patient eligibility

About

The purpose of this study is to determine whether an educational intervention given towards health care providers working in primary health care centers can reduce inappropriate prescribing in the elderly patient and thus reduce number and length of drug-related hospitalizations as well as number of emergency department visits in this patient group.

Full description

Inappropriate medication in the elderly patient leads to substantial morbidity, possibly causing up to 20% of hospitalizations in this patient group (1). To improve prescribing and thus reduce undesired drug effects is a great challenge for doctors and nurses in primary health care.

Performance of drug utilization reviews is recommended in order to reduce the negative impact of inappropriate prescribing in the elderly. However, scientific evidence on their efficacy is lacking, especially regarding patient-related health outcomes (2,3). Most studies are carried out in inpatient care, making it difficult to draw conclusions regarding primary health care (2). Moreover, studies in this scientific field diverge regarding the content and structure of drug utilization reviews, which implies that comparison between studies becomes challenging, if not impossible.

This trial aims at educating health care providers in how to perform drug utilization reviews, and to help them implement theory into practice.

Enrollment: 69 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• primary health care center in Stockholm County
• authorized by Stockholm County Council since at least 3 years
• at least 5% of patients attributed to primary health care center are 65 years and older
• primary health care center takes care of at least 10 home care patients

Exclusion criteria

• less than 3000 patients listed in primary health care center
• primary health care centers where researchers carrying out the present study work

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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69 participants in 2 patient groups

Educational intervention

Experimental group

Description:

Primary health care centers (PHCC) in the intervention group will be visited twice by a pharmacist within a period of three months. At the first visit, an educational intervention will focus on two properties: on the one hand, feed-back of actual patient data of the PHCC illustrating the primary-health-care-specific characteristics of inappropriate prescribing in the elderly patient will be given. Education of relevant subjects will be given in relation to detected problems. On the other hand, a clinical routine regarding the performance of drug utilization reviews will be developed in cooperation with the health care providers. At the second visit 3 months later, the developed concept will be critically reviewed and eventually developed further.

Treatment:

Other: Educational intervention

Delayed educational intervention

No Intervention group

Description:

Primary health care centers in the delayed intervention group will receive the same intervention as described above with 9 months delay.