gms | German Medical Science

Background: Patients with dementia bear an increased risk for comorbidities and reduced life expectancy. These characteristics are associated with polypharmacy, a higher risk of adverse drug reactions and an increased need for medical care. In light of this problem, an innovative GP-based care concept for patients with dementia will be tested in Rhineland-Palatinate starting this September. Within the multi-professional concept, clinical pharmacists will regularly conduct structured medication analyses with the aim of improving the quality and safety of the drug therapy.

Materials and methods: A prospective cluster randomized intervention study will be performed. During the study period of 27 months, approximately 1600 patients with dementia will be recruited by general practitioners. About 800 patients each will be randomized to the intervention group or the control group. A medication analysis will be performed for each patient at the time point of study enrolment. For patients in the intervention group, medication analysis will be performed quarterly (maximum to month 9 after enrolment) and, if necessary, in case of crisis.

The medication analysis includes assessing the appropriateness of medication using the Medication Appropriateness Index (MAI), reducing multimedication by using defined deprescribing strategies and identifying potentially inadequate medication (PIM) for geriatric patients. The attending general practitioners are alerted to inappropriate medication and drug-related problems (DRP). Suggestions for solutions are offered and documented in the patient’s electronic case file.

Results: The study concept and the approach for the medication analysis are presented in detail.

Conclusion: Innovation fund projects can be used to examine whether and to what extent drug therapy safety can be improved through interdisciplinary cooperation and pharmaceutical interventions. Standardized tools may support the optimal therapeutic approach.