An Intervention to Reduce Inappropriate Medications in Long-term Care Residents With Severe Dementia

Study Overview
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Brief Summary
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An education intervention to promote medication reviews and interdisciplinary discussions within long-term care facilities with the aim of improving medication regimen among residents with severe dementia

Detailed Description
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A quasi-experimental study in three long-term care facilities. The intervention comprises an information leaflet for families of residents, a 90-minute knowledge exchange session for general practitioners, pharmacists and nurses and a list of generally, sometimes, and exceptionally appropriate medications for severe dementia residents

Official Title
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The OptimaMed Intervention to Reduce Inappropriate Medications in Long-term Care Residents With Severe Dementia: Results From a Quasi-experimental Intervention Study

Conditions
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Dementia, Inappropriate Prescribing

Intervention / Treatment
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* Behavioral: Knowledge exchange


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of dementia of any etiology severe dementia Exclusion Criteria: admission less than 2 months before intervention

Ages Eligible for Study
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Minimum Age: 65 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: Health Services Research
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Interventional Model Description: Pre-post study
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Pre-intervention<br>Usual care | |
| Experimental: Post-intervention<br>One 90-minute interdisciplinary knowledge exchange including the provision of a validated list of appropriate and inappropriate medications for severe dementia long-term care residents. | Behavioral: Knowledge exchange<br>* OptimaMed<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medication regimen | Active prescriptions | Four months post intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Level of pain | Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). The French version of the PACSLAC tool is a validated observational scale in use in Quebec to assess discomfort / pain. One point is added to the score for each PACSLAC item (n=60) observed over a 15-minute observation period; the sum of the four 15-minute observation periods gives the total score. The total score ranges from zero to sixty where zero represents no discomfort or pain and sixty a very high level of discomfort or pain. | Four months post intervention | 
| Level of agitation | Cohen-Mansfield Agitation Inventory () measures level of agitation. Sum of the number of times the Cohen-Mansfield Agitation Inventory items were observed during the four 15-minute observation periods.. The total score ranges from zero to one hundred where zero represents no agitation and one hundred a very high level of agitation. | Four months post intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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quality improvement, long term care, polypharmacy