TY  - JOUR
PY  - 2021//
TI  - Drug safety for nursing-home residents - findings of a pragmatic, cluster-randomized, controlled intervention trial in 44 nursing homes
JO  - Deutsches Ärzteblatt International
A1  - Junius-Walker, Ulrike
A1  - Krause, Olaf
A1  - Thürmann, Petra
A1  - Bernhard, Simone
A1  - Fuchs, Angela
A1  - Sparenberg, Lisa
A1  - Wollny, Anja
A1  - Stolz, Regina
A1  - Haumann, Hannah
A1  - Freytag, Antje
A1  - Kirsch, Claudia
A1  - Usacheva, Svetlana
A1  - Wilm, Stefan
A1  - Wiese, Birgitt
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: The safety of drug use by nursing-home residents can be impaired by polypharmacy, potentially inappropriate medications (PIM), and neuroleptics, as well as by a lack of adequate interprofessional coordination in the nursing home. The goal of the HIOPP-3- iTBX Trial was to improve drug safety in nursing-home residents, including a reduction of PIM and/or neuroleptic use, by means of a complex interprofessional intervention. <br><br>METHODS: This cluster-randomized, controlled trial was performed in nursing homes in Germany. Residents over age 65 were included in the trial. The intervention was carried out over six months and consisted of four elements: a drug review by trained pharmacists, educational sessions for general practitioners and nurses, a drug safety toolbox, and change management seminars for members of the three participating professions. The nursing homes in the control group continued to provide usual care. The primary endpoint was the prescription of at least one PIM and/or at least two neuroleptic drugs simultaneously. The secondary endpoints were the incidence of falls and hospitalizations, quality of life, and health-care costs. This trial is registered in the German Clinical Trials Registry (DRKS00013588). <br><br>RESULTS: 44 nursing homes with 862 residents were randomized, 23 of them (with 452 residents) to the intervention group and 21 (with 410 residents) to the control group. 41% of all nursinghome residents initially took at least one PIM and/or at least two neuroleptic drugs simultaneously. Follow-up data (including, among other things, the current drug regimen) were obtained for 773 residents. The intention-to-treat analysis continued to show no difference between the intervention group and the control group with respect to the primary endpoint. <br><br>CONCLUSION: This trial of an intervention to improve drug safety in nursing homes led neither to reduced prescribing of PIM and/or neuroleptic drugs, nor to any improvement in the overall health status of the nursing-home residents.<p />  <p>Language: en</p>
LA  - en
SN  - 1866-0452
UR  - http://dx.doi.org/10.3238/arztebl.m2021.0297
ID  - ref1
ER  -