Abstract
BackgroundMultimorbidity, polypharmacy, and older age predispose seniors to adverse drug events (ADE). Seniors with an ADE experience greater morbidity, mortality, and health care utilization compared to their younger counterparts. To mitigate and manage ADEs among this vulnerable population, we designed a geriatric pharmacology consultation service connecting clinicians with specialist physicians and pharmacists and will investigate the feasibility and acceptability of this complex intervention in the long-term care setting, prior to conducting a larger efficacy trial.Methods/DesignWe will conduct a cluster randomized feasibility trial and qualitative analysis of GeriMedRisk among four long-term care homes in the Waterloo-Wellington region from May 1 to December 31, 2017. The primary outcome is the feasibility and acceptability of GeriMedRisk and the stepped-wedge cluster randomized controlled trial design. We hypothesize that GeriMedRisk is a feasible intervention and its potential to decrease falls and drug-related hospital visits can be evaluated with a stepped-wedge cluster randomized controlled trial design.DiscussionThis mixed methods study will inform a larger efficacy trial of GeriMedRisk’s ability to decrease adverse drug events among seniors in the long-term care setting.Ethics and disseminationThe Hamilton Integrated Research Ethics Board granted the approval for this study protocol 2812. We plan to disseminate the results of this study in peer-reviewed journals and also to our partners and stakeholders.Trial registrationISRCTN clinical trials registry, ISRCTN17219647 (March 27, 2017)
Highlights
Multimorbidity, polypharmacy, and older age predispose seniors to adverse drug events (ADE)
The Ontario Pharmacy Research Network (OPEN), found that a minority of patients receiving a Medscheck were older and medically complex and that there was a discrepancy in the quality of the delivered service, and there was no evidence of improved patient outcomes [8]
The aim of this study is to investigate the feasibility and acceptability of the GeriMedRisk and its evaluation with a stepped-wedge randomized controlled trial in the long-term care (LTC) setting
Summary
Multimorbidity, polypharmacy, and older age predispose seniors to adverse drug events (ADE). To mitigate and manage ADEs among this vulnerable population, we designed a geriatric pharmacology consultation service connecting clinicians with specialist physicians and pharmacists and will investigate the feasibility and acceptability of this complex intervention in the long-term care setting, prior to conducting a larger efficacy trial. Tens of thousands of seniors experience a poisoning or adverse drug event (ADE) [1, 2]. Polypharmacy, and age predispose older adults to drug toxicity. Seniors (aged ≥ 65 years) are four times more likely to die or to require hospitalization compared to their younger. There is a need for a timely and cost-effective geriatric pharmacology consultation service for Ontario seniors irrespective of their location
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