Article Text
Abstract
Introduction Polypharmacy and potentially inappropriate medication use is common in older adults and is associated with adverse outcomes such as falls and hospitalisations.
Methods and analysis This study is a pharmacist-led medication optimisation initiative using an electronic tool (the Drug Burden Index (DBI) Calculator) in four hospital sites in the Canadian province of Nova Scotia. The study aims to enrol 160 participants between the preintervention and intervention groups. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT 2013 checklist) was used to develop the protocol for this prospective interventional implementation study. A preintervention retrospective control cohort and a multiple case study analysis will also be used to assess the effect of intervention implementation. Statistical analysis will involve change in DBI scores and assessment of clinical outcomes, such as rehospitalisation and mortality using appropriate statistical tests including t-test, χ2, analysis of variance and unadjusted and adjusted regression methods.
Ethics and dissemination Ethics approval has been granted by the Nova Scotia Health Authority Research Ethics Board. The findings of this study will be published in peer-reviewed journals and presented at local, national and international conferences.
Trial registration number NCT03698487.
- geriatric medicine
- clinical pharmacology
- adverse events
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Footnotes
Twitter @lisakouladjian, @Reeve_Research
Contributors MED and ER contributed to the concept and design of this study and this manuscript, drafted the manuscript, revised the manuscript based on coauthor feedback and approved the final version for submission. SB, JI, KT, OK, LKO, HN, SH, CS, MH, AN and KR contributed to the concept and design of this study and this manuscript, reviewed the manuscript and approved the final version for submission.
Funding This work was supported by the Canadian Frailty Network 2017 Catalyst Grant Competition, grant number CAT2017-13. In addition, funding for the follow-up phase was supported by the Nova Scotia Health Authority Research Fund and the Dalhousie (University) Pharmacy Endowment Fund. ER is supported by an NHMRC-ARC Dementia Research Development Fellowship.
Disclaimer The funders had no role in the study design; collection, management, analysis and interpretation of data; writing of the report; or the decision to submit the report for publication.
Competing interests The Drug Burden Index (DBI) Calculator Copyright 2019 The University of Sydney. All rights reserved. SH and LKO are the developers of the DBI Calculator.
Patient consent for publication Not required.
Ethics approval The intervention study protocol (including the multiple-case study) was approved by the Nova Scotia Health Authority (NSHA) Research Ethics Board (REB) on November 20, 2018 (File No. 1023962). The pre-intervention was approved July 19, 2018 (File No. 1023666). The first participant was consented on 6 February 2019.
Provenance and peer review Not commissioned; externally peer reviewed.