Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial
Introduction Drug-related problems (DRPs) are common in the elderly, leading to suboptimal therapy, hospitalisations and increased mortality. The integrated medicines management (IMM) model is a multifactorial interdisciplinary methodology aiming to optimise individual medication therapy throughout...
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BMJ Publishing Group
2018-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/8/1/e020106.full |
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| author | Liv Mathiesen Jeanette Schultz Johansen Kjerstin Havnes Kjell H. Halvorsen Stine Haustreis Lillann Wilsgård Skaue Elena Kamycheva Kirsten K. Viktil Anne Gerd Granås Beate H. Garcia |
| author_facet | Liv Mathiesen Jeanette Schultz Johansen Kjerstin Havnes Kjell H. Halvorsen Stine Haustreis Lillann Wilsgård Skaue Elena Kamycheva Kirsten K. Viktil Anne Gerd Granås Beate H. Garcia |
| author_sort | Liv Mathiesen |
| collection | DOAJ |
| description | Introduction Drug-related problems (DRPs) are common in the elderly, leading to suboptimal therapy, hospitalisations and increased mortality. The integrated medicines management (IMM) model is a multifactorial interdisciplinary methodology aiming to optimise individual medication therapy throughout the hospital stay. IMM has been shown to reduce readmissions and drug-related hospital readmissions. Using the IMM model as a template, we have designed an intervention aiming both to improve medication safety in hospitals, and communication across the secondary and primary care interface. This paper presents the study protocol to explore the effects of the intervention with regard to healthcare use, health-related quality of life (HRQoL) and medication appropriateness in elderly patients.Methods and analysis A total of 500 patients aged ≥70 years will be included and randomised to control (standard care) or intervention group (1:1). The intervention comprises five steps mainly performed by pharmacists: (1) medication reconciliation at admission, (2) medication review during hospital stay, (3) patient counselling about the use of medicines, (4) a comprehensible and patient-friendly medication list with explanations in discharge summary and (5) postdischarge phone calls to the primary care level. The primary outcome is the difference between intervention and control patients in the rate of emergency medical visits (acute readmissions and visits to emergency department) 12 months after discharge. Secondary outcomes include length of index hospital stay, time to first readmission, mortality, hip fractures, strokes, medication changes, HRQoL and medication appropriateness. Patient inclusion started in September 2016.Ethics and dissemination The trial was approved by the Norwegian Centre for Research Data and the Norwegian Data Protection Authority. We aim to publish the results in international peer-reviewed open access journals, at national and international conferences, and as part of two PhD theses.Trial registration number NCT02816086. |
| format | Article |
| id | doaj-art-c67338878e7848bbaaf85769565e9175 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c67338878e7848bbaaf85769565e91752025-02-12T00:25:14ZengBMJ Publishing GroupBMJ Open2044-60552018-01-018110.1136/bmjopen-2017-020106Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trialLiv Mathiesen0Jeanette Schultz Johansen1Kjerstin Havnes2Kjell H. Halvorsen3Stine Haustreis4Lillann Wilsgård Skaue5Elena Kamycheva6Kirsten K. Viktil7Anne Gerd Granås8Beate H. Garcia9Department of Pharmacy, University of Oslo, Oslo, Norway1 Department of Pharmacy, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway1 Department of Pharmacy, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway1 Department of Pharmacy, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway2 Hospital Pharmacy of North Norway Trust, Tromsø, Norway2 Hospital Pharmacy of North Norway Trust, Tromsø, Norway3 Department of Medicine, University Hospital of North Norway, Tromsø, Norway5 School of Pharmacy, University of Oslo, Oslo, Norway5 School of Pharmacy, University of Oslo, Oslo, Norway1 Department of Pharmacy, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, NorwayIntroduction Drug-related problems (DRPs) are common in the elderly, leading to suboptimal therapy, hospitalisations and increased mortality. The integrated medicines management (IMM) model is a multifactorial interdisciplinary methodology aiming to optimise individual medication therapy throughout the hospital stay. IMM has been shown to reduce readmissions and drug-related hospital readmissions. Using the IMM model as a template, we have designed an intervention aiming both to improve medication safety in hospitals, and communication across the secondary and primary care interface. This paper presents the study protocol to explore the effects of the intervention with regard to healthcare use, health-related quality of life (HRQoL) and medication appropriateness in elderly patients.Methods and analysis A total of 500 patients aged ≥70 years will be included and randomised to control (standard care) or intervention group (1:1). The intervention comprises five steps mainly performed by pharmacists: (1) medication reconciliation at admission, (2) medication review during hospital stay, (3) patient counselling about the use of medicines, (4) a comprehensible and patient-friendly medication list with explanations in discharge summary and (5) postdischarge phone calls to the primary care level. The primary outcome is the difference between intervention and control patients in the rate of emergency medical visits (acute readmissions and visits to emergency department) 12 months after discharge. Secondary outcomes include length of index hospital stay, time to first readmission, mortality, hip fractures, strokes, medication changes, HRQoL and medication appropriateness. Patient inclusion started in September 2016.Ethics and dissemination The trial was approved by the Norwegian Centre for Research Data and the Norwegian Data Protection Authority. We aim to publish the results in international peer-reviewed open access journals, at national and international conferences, and as part of two PhD theses.Trial registration number NCT02816086.https://bmjopen.bmj.com/content/8/1/e020106.full |
| spellingShingle | Liv Mathiesen Jeanette Schultz Johansen Kjerstin Havnes Kjell H. Halvorsen Stine Haustreis Lillann Wilsgård Skaue Elena Kamycheva Kirsten K. Viktil Anne Gerd Granås Beate H. Garcia Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial BMJ Open |
| title | Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial |
| title_full | Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial |
| title_fullStr | Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial |
| title_full_unstemmed | Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial |
| title_short | Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial |
| title_sort | interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly immense study study protocol for a randomised controlled trial |
| url | https://bmjopen.bmj.com/content/8/1/e020106.full |
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