Medication Reviews in Elderly in Primary Care

Study Overview
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Brief Summary
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The study is a follow-up of a randomized controlled study performed in 2011-2012 with medication reviews in elderly patients in Sweden. Additional data about mortality and hospital admissions have been collected.

Detailed Description
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Background Drug-related problems among the elderly population are common and increasing. Multi-professional medication reviews (MR) have arisen as a method to optimize drug therapy for frail elderly patients. Research has not yet been able to show conclusive evidence of the effect of MRs on mortality or hospital admissions. Aim The aim of this study was to assess the impact of MRs' on hospital admissions and mortality after six and 12 months in a frail population of 369 patients in primary care in a randomized controlled study. Methods Patients were blindly randomized to an intervention group (receiving MRs) and a control group (receiving usual care). Descriptive data on mortality and hospital admissions at six and 12 months were collected. Survival analysis was performed for time to death and time to the first hospital admission within 12 months.

Official Title
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The Impact of Medication Reviews Conducted in Primary Care on Hospital Admissions and Mortality - a Randomized Controlled Trial

Conditions
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Drug Utilization Review

Intervention / Treatment
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* Other: Medication review


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age>75 years, living in nursing homes or community-dwelling with municipality-provided care, with multi-dose drug dispensing Exclusion Criteria: lack of multi-dose drug dispensing, living at home with no municipality-provided care, <75 years old

Ages Eligible for Study
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Minimum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Patients were blindly randomized to intervention or control group in 2011. This study is a follow-up with additional data collection for the included patient, a total of 369.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Patients in the intervention groups received multi-professional medication reviews. A nurse performed a symptom evaluation, a pharmacist assessed the drug list and made adjustment suggestions and finally a physician took action and performed medication changes. | Other: Medication review<br>* Multi-professional medication review<br>|
| No Intervention: Control<br>Patients were treated according to the usual routine. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hospital admission | time to the first hospital admission | six months | 
| hospital admission | time to the first hospital admission | twelve months | 
| Survival analysis | time to death | six months | 
| Survival analysis | time to death | twelve months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of hospital admissions | number of hospital admissions | six months | 
| number of hospital admissions | number of hospital admissions | twelve months | 
| mortality | number of deaths | six months | 
| mortality | number of deaths | twelve months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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medication reviews, elderly, primary care