Non-adherence and Polypharmacy in Elderly Patients

NCT ID: NCT02424786

Last Updated: 2017-09-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-31

Study Completion Date

2017-09-30

Brief Summary

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The study aims to investigate adherence and polypharmacy in elderly patients with chronic kidney disease (CKD) and End Stage Renal Disease (ESRD). The investigators look into possible factors or predictors that may affect adherence and reduce polypharmacy. Factors could be: quality of life, anxiety and depression, beliefs about medicine and cognitive impairment.

The investigators are planning an intervention with the screening tool Screening Tool of Older Person's potentially inappropriate Prescription/Screening tool to Alert to Right Treatment (STOPP/START ) criteria to evaluate medication lists of the participating patients.

Detailed Description

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The investigators intend to include all patients \> 65 years old, in dialysis treatment (hemodialysis and peritoneal dialysis), as well as patients with CKD stage 5.

The recruitment will be done as follows:

The patients will be screened according to inclusion criteria. Afterwards each patient will be invited to a first meeting that explains the aim of the study, giving the opportunity for discussion and consideration, and presenting the consent information. After giving the consent the patient will be invited to a second meeting with blood tests, data registration, medication registration, undergoing MMS and handing over the questionnaires forms.

Randomization:

After the initial assessment and compliance with the eligibility criteria, participants will be randomized into an intervention group (medication list will be evaluated by STOPP/START criteria) and a control group (medication list will not be evaluated by STOPP/START criteria). Randomization numbers will be generated by a random number generator. A series of numbered, sealed, opaque envelopes will be used to ensure confidentiality. Each envelope will contain a card with information about the group allocation. The group allocation is concealed from the researcher and patients at baseline registration.

Each patients will get questionnaires for: Quality of life using Kidney Disease Quality of Life - Short form 36 (KDQOL-Short form 36 ) and EuroQoL-3D (EQ-3D), beliefs about medicine, Hospital Anxiety and Depression Scale (HADS), Morisky medication adherence scale and visual adherence scale (VAS), sleeping related questionnaires (Epworth, Berlin, Pittsburgh). A Mini Mental Status (MMS) test will be done regarding cognitive function.

Each patients will get the opportunity to have a polysomnograph for one night.

With STOPP/START criteria the medication list will be evaluated for the patients who are randomized in the intervention group.

Conditions

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Adherence

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Intervention group

Medication lists from the patients randomized in the intervention group will be evaluated by the research physician with the help of STOPP/START criteria.

Feedback of this screening will be given to the team responsible for patient treatment.

Group Type OTHER

STOPP/START criteria

Intervention Type OTHER

Evaluation of medication lists

Control

Patients in this arm will receive standard pharmacological treatment

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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STOPP/START criteria

Evaluation of medication lists

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All patients \> 65 years with CKD, stage 5 (eGFR ≤ 12 ml/min), or undergoing treatment with hemodialysis and peritoneal dialysis

Exclusion Criteria

* Patients not willing to participate
* Patients diagnosed with dementia or severe cognitive disorder (MMS \< 25),
* Patients with hearing impairment
* Patients with language difficulties
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Akershus

OTHER

Sponsor Role lead

Responsible Party

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Krystina Parker

MD, pHD-student

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Knut Stavem, Professor

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Akershus

Ingrid Os

Role: PRINCIPAL_INVESTIGATOR

Univeristy Hospital, Ullevål

Locations

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Vestre Viken Sykehus

Drammen, , Norway

Site Status

University Hospital, Ullevål

Oslo, , Norway

Site Status

University Hospital, Akershus

Oslo, , Norway

Site Status

Countries

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Norway

References

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Parker K, Bull-Engelstad I, Benth JS, Aasebo W, von der Lippe N, Reier-Nilsen M, Os I, Stavem K. Effectiveness of using STOPP/START criteria to identify potentially inappropriate medication in people aged >/= 65 years with chronic kidney disease: a randomized clinical trial. Eur J Clin Pharmacol. 2019 Nov;75(11):1503-1511. doi: 10.1007/s00228-019-02727-9. Epub 2019 Jul 29.

Reference Type DERIVED
PMID: 31359099 (View on PubMed)

Other Identifiers

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15-068

Identifier Type: -

Identifier Source: org_study_id