Nursing Home Team-Care Deprescribing Study

Nursing Home Team-Care Deprescribing Study

Sponsors

Lead sponsor: Tan Tock Seng Hospital

Collaborator: Monash University
National Healthcare Group, Singapore

Source Tan Tock Seng Hospital
Brief Summary

This is a multi-centre study in Singapore nursing homes, investigating the factors that affecting deprescribing, and if a team-care based deprescribing standard practice gives superior health and pharmacoeconomic outcomes over current medication review practice.

Overall Status Completed
Start Date November 2016
Completion Date April 2018
Primary Completion Date March 2018
Phase N/A
Study Type Interventional
Primary Outcome
Measure Time Frame
Change from baseline in Fall Risk Assessment Tool (FRAT) score Change from baseline in FRAT score at 3 months
Change from baseline in Fall Risk Assessment Tool (FRAT) score Change from baseline in FRAT score at 6 months
Change from baseline in Fall Risk Assessment Tool (FRAT) score Change from baseline in FRAT score at 12 months
Change from baseline in fall rate Change from baseline in fall rate at 3 months
Change from baseline in fall rate Change from baseline in fall rate at 6 months
Change from baseline in fall rate Change from baseline in fall rate at 12 months
Secondary Outcome
Measure Time Frame
Factors affecting deprescribing 0 month
Change from baseline in mean number of medications per subject Change from baseline in mean number of medications per subject at 3 months
Change from baseline in mean number of medications per subject Change from baseline in mean number of medications per subject at 6 months
Change from baseline in mean number of medications per subject Change from baseline in mean number of medications per subject at 12 months
Change from baseline in mean medication cost per subject Change from baseline in mean medication cost at 3 months
Change from baseline in mean medication cost per subject Change from baseline in mean medication cost at 6 months
Change from baseline in mean medication cost per subject Change from baseline in mean medication cost at 12 months
Change from baseline in deprescribing intervention acceptance rate Change from baseline in deprescribing intervention acceptance rate at 3 months
Change from baseline in deprescribing intervention acceptance rate Change from baseline in deprescribing intervention acceptance rate at 6 months
Change from baseline in deprescribing intervention acceptance rate Change from baseline in deprescribing intervention acceptance rate at 12 months
Change from baseline in percentage of drug-related problems (DRPs) Change from baseline in percentage of DRPs at 3 months
Change from baseline in percentage of drug-related problems (DRPs) Change from baseline in percentage of DRPs at 6 months
Change from baseline in percentage of drug-related problems (DRPs) Change from baseline in percentage of DRPs at 12 months
Enrollment 295
Condition
Intervention

Intervention type: Other

Intervention name: Team-care deprescribing with deprescribing guide

Description: Beers criteria 2015, STOPP criteria 2014, drug interaction

Eligibility

Criteria:

For interview questionnaire:

Inclusion criteria are:

1. Accepted informed consent,

2. The healthcare professional is practicing in the involved nursing homes.

Exclusion criteria are:

1) Decline/unable to provide consent.

For team-care deprescribing study:

Inclusion criteria are:

1. Accepted informed consent (unless cognitive-impaired, with no or un-contactable next-of-kin),

2. Adult aged 65 years and above,

3. Currently on five or more medications.

Exclusion criteria are:

1. Below the age of 65 years of age,

2. Life expectancy of less than 6 months or respite care.

Gender: All

Minimum age: 65 Years

Maximum age: N/A

Healthy volunteers: No

Overall Official
Last Name Role Affiliation
Chong Han Kua Principal Investigator Monash University/Tan Tock Seng Hospital
Location
facility Nursing homes
Location Countries

Singapore

Verification Date

April 2018

Responsible Party

Responsible party type: Principal Investigator

Investigator affiliation: Tan Tock Seng Hospital

Investigator full name: Kua Chong Han

Investigator title: PhD Intern

Has Expanded Access No
Number Of Arms 4
Arm Group

Arm group label: naive Deprescribing arm

Arm group type: Experimental

Description: Team-based deprescribing practice, Deprescribing Guide

Arm group label: naive Wait-list Control arm

Arm group type: No Intervention

Arm group label: non-naive Deprescribing arm

Arm group type: Experimental

Description: Team-based deprescribing practice, Deprescribing Guide

Arm group label: non-naive Wait-list Control arm

Arm group type: No Intervention

Study Design Info

Allocation: Randomized

Intervention model: Crossover Assignment

Primary purpose: Health Services Research

Masking: Single (Outcomes Assessor)

Source: ClinicalTrials.gov