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19. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie (GAA)

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

22.11. - 23.11.2012, Jena

A multi-center prospective interventional study for improving drug safety in German nursing homes

Meeting Abstract

  • corresponding author Simone Bernard - Universität Witten/Herdecke, Department für Humanmedizin, Fakultät für Gesundheit, Witten/Herdecke, Germany
  • author Petra A. Thürmann - Universität Witten/Herdecke, Lehrstuhl für Klinische Pharmakologie, Department für Humanmedizin, Fakultät für Gesundheit, Witten/Herdecke, Germany
  • Ulrich Jaehde - Universität Bonn, Pharmazeutisches Institut, Klinische Pharmazie, Bonn, Germany
  • Stefan Wilm - Universitätsklinikum Düsseldorf, Institut für Allgemeinmedizin, Düsseldorf, Germany
  • Attila Altiner - Universitätsmedizin Rostock, Institut für Allgemeinmedizin, Rostock, Germany
  • Bernd Drewelow - Universitätsmedizin Rostock, Institut für Klinische Pharmakologie, Rostock, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 19. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Jena, 22.-23.11.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12gaa01

DOI: 10.3205/12gaa01, URN: urn:nbn:de:0183-12gaa014

Veröffentlicht: 14. November 2012

© 2012 Bernard et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: In Germany approx. 800,000 seniors live in nursing homes. Their mean age comes to about 82 years, most of them suffer from multimorbidity and receive highly complex medication regimens. Therefore, these nursing home residents bear a high risk to develop adverse drug events (ADE). Whereas different interventional strategies for reducing ADE have been examined in several countries, only limited data are available for Germany. The aim of this project is the reduction of avoidable and ameliorable ADE by implementation of a previously published interdisciplinary intervention, where feasibility could be demonstrated [1].

Materials and Methods: In this prospective intervention study data on medication use and ADE from approx. 1000 nursing home residents in at least 15 nursing homes in North Rhine-Westphalia and Mecklenburg/Vorpommern will be collected by trained pharmacists. The intervention study will include three cross-sectional analyses, were ADE will be quantified and evaluated. After the first cross-sectional analysis will follow an interdisciplinary intervention including a) peer-to-peer education for primary care physicians, b) geriatric pharmacotherapy training for home supplying pharmacists and c) geriatric pharmacology training for nursing staff. In addition, drug safety teams will be established in nursing homes to recognize drug-related problems already in early stages and to communicate findings appropriately to the treating physicians. The second and third collection of ADE will be carried out after 6 and 12 months, respectively, to allow for assessment of the effectiveness and the sustainability of the intervention.

As primary endpoint of our study, reduction of ADE will be analyzed by comparing 30-day-prevalence of ADE of the pre-interventional assessment versus 6 months after starting the intervention (adjusted for nursing homes). As secondary endpoints, newly occurring ADE and number of relevant clinical endpoints (e.g. hospitalization) will be evaluated. Furthermore, long-term effects on ADE will be examined by comparing 30-day ADE prevalence of the assessments at 6 versus 12 months after beginning of the intervention.

Results: Results of this study will allow a quantification of ADE reduction after a multidisciplinary intervention in nursing homes and the medical, nursing and economic consequences will be determined for Germany (funded by the German Federal Ministry of Health, IIA5-2512FSB503).

Conclusion: In order to recognize and to prevent ADE, effective communication is crucial, and all involved healthcare professionals guilds should develop therapeutic partnership with patients and caregivers. In addition, key elements of geriatric pharmacotherapy may allow for early recognition of drug-related problems and also for differentiation between “new diseases” and ADE. Intensification of communication may allow to detect and to eliminate ADE at an early stage. Acceptance and recognition of the achievements of all healthcare professionals involved should strengthen the motivation of participants, facilitate the identification of problems and serve the benefit of the patient.


References

1.
Thürmann P, et al. Arzneimitteltherapiesicherheit in Alten- und Pflegeheimen. In: 10. Deutscher Kongress für Versorgungsforschung. 18. GAA-Jahrestagung. Köln, 20.-22.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dkvf015. DOI: 10.3205/11dkvf015, URN: urn:nbn:de:0183-11dkvf0151 Externer Link