HIOPP-3: Interprofessional optimization of medication in nursing home residents – a cluster randomized controlled trial

Background and Purpose: Polypharmacy and potentially inadequate medication (PIM) such as neuroleptics are common in elderly nursing home residents. A lack of collaboration between health care professionals (HCP) involved in the medication process – general practitioners (GP), pharmacists and nurses – can lead to inadequate polypharmacy and PIM. HIOPP-3 aims to improve 1. medication safety with focus on number of PIM and neuroleptics and 2. the medication process in nursing homes by the use of an interprofessional toolbox.

Methods: Multi-centre cluster randomized controlled trial.

Research Focus: Sample size planned:760 nursing home residents ≥ 65 years in 32 nursing homes at 4 regions. A tailored intervention is applied in every nursing home. Main aspects are 1. medication review by pharmacists, 2. interprofessional toolbox incl. workshops and information material for HCPs aiming to initiate a change management process in HCP teams focusing on the collaboration in the medication process. Data will be collected at baseline and after 6 months.

Primary endpoint is the number of PIM/neuroleptics, evaluated by multilevel logistical regression model. Secondary endpoints are e.g. hospitalization rates, length of hospital stays, falls, quality of life, health economic evaluation, analyzed by mixed regression models.

Methodological and Theoretical Focus: Randomized-controlled trial with qualitative and quantitative process evaluation to optimize medication safety in nursing home residents.

Results: HIOPP-3 is in the recruiting phase. The presentation will include the study protocol and first experiences with the intervention.

Conclusions: HIOPP-3 aims to improve inter-professional collaboration in the medication process and thereby medication safety in nursing home facilities.

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