Pharmacist-led intervention to improve medication use in older inpatients using the Drug Burden Index: a study protocol for a before/after intervention with a retrospective control group and multiple case analysis
Kenneth Rockwood,
Sarah Hilmer,
Emily Reeve,
Mohammad Hajizadeh,
Marci Elizabeth Dearing,
Susan Bowles,
Jennifer Isenor,
Olga Kits,
Lisa Kouladjian O'Donnell,
Heather Neville,
Kent Toombs,
Caroline Sirois,
Aprill Negus
Affiliations
Kenneth Rockwood
5 Dalhousie University, Halifax, Nova Scotia, Canada
Sarah Hilmer
3 Department of Clinical Pharmacology and Aged Care, Kolling Institute of Medical Research, Royal North Shore Hospital School, Saint Leonards, New South Wales, Australia
Emily Reeve
9 Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
Mohammad Hajizadeh
School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
Marci Elizabeth Dearing
Geriatric Medicine Research, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Susan Bowles
Department of Pharmacy, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Jennifer Isenor
College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
Olga Kits
Research Methods Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Lisa Kouladjian O'Donnell
NHMRC Cognitive Decline Partnership Centre, Kolling Institute of Medical Research, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
Heather Neville
Department of Pharmacy, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Kent Toombs
Department of Pharmacy, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
Caroline Sirois
Department of Social and Preventive Medicine, Faculty of Medicine, Universite Laval, Québec city, Quebec, Canada
Aprill Negus
Department of Family Medicine, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
IntroductionPolypharmacy and potentially inappropriate medication use is common in older adults and is associated with adverse outcomes such as falls and hospitalisations.Methods and analysisThis 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 disseminationEthics 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 numberNCT03698487.
