scholarly journals Patient safety, cost-effectiveness, and quality of life: reduction of delirium risk and postoperative cognitive dysfunction after elective procedures in older adults—study protocol for a stepped-wedge cluster randomized trial (PAWEL Study)

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Alba Sánchez ◽  
◽  
Christine Thomas ◽  
Friederike Deeken ◽  
Sören Wagner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Patient Safety ◽  
Cost Effectiveness ◽  
Randomized Trial ◽  
Postoperative Cognitive Dysfunction ◽  
Cluster Randomized Trial ◽  
Stepped Wedge ◽  
Cluster Randomized

scholarly journals Spread and scale of an electronic deprescribing software to improve health outcomes of older adults living in nursing homes: study protocol for a stepped wedge cluster randomized trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marc-Eric Nadeau ◽  
Justine L. Henry ◽  
Todd C. Lee ◽  
Émilie Bortolussi-Courval ◽  
Carole Goodine ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Trial ◽  
Study Design ◽  
Long Term Care ◽  
Cluster Randomized Trial ◽  
Stepped Wedge ◽  
Term Care ◽  
Medication Reviews ◽  
Cluster Randomized

Abstract Background Medication overload or problematic polypharmacy is a major problem causing widespread harm, particularly to older adults. Taking multiple medications increases the risk of potentially inappropriate medications (PIMs), and residents in long-term care (LTC) are frequently prescribed 10 or more medications at once. One strategy to address this problem is for the physician and/or pharmacist to perform regular medication reviews; however, this process can be complicated and time-consuming. With a prescription review, medications may be decreased, changed, or stopped altogether. MedReviewRx is a software that runs an analysis using deprescribing rules to produce a report to guide medication reviews addressing medication overload for residents in LTC. Methods This study will employ a mixed methods effectiveness-implementation hybrid type 2 study design. To measure effectiveness, a stepped wedge cluster randomized trial design is planned, which allows us to approximate a randomized clinical trial. Approximately 1000 residents living in LTC will be recruited from five facilities in New Brunswick. The study will begin with 3 months of baseline data on rates of deprescribing. Thereafter, every 3 months a new cluster will enter the intervention mode. The intervention consists of medication reviews augmented with the MedReviewRx software, which will be used by staff and clinicians in the facilities. The estimated study duration is 18 months and the main outcome will be the proportion of patients with one or more PIMs deprescribed (reduced/stopped or changed to a safer alternative) in the 90 days following a prescription review. The goal is to study the impact of MedReviewRx on medication overload among older adults living in LTC. In typical fashion of a stepped wedge cluster randomized trial, each cluster acts as an internal control (before and after) as well as a control for the other clusters (external control). Qualitative data collected will include resident/caregiver attitudes towards deprescribing and semi-structured interviews with staff working in the long-term care homes. Discussion This study design addresses issues with seasonality and allows all clusters to participate in the intervention, which is an advantage when the intervention is related to quality improvement. This study will provide valuable information on PIM use, cost savings, and facilitators and challenges associated with medication reviews and deprescribing. This study represents an important step towards understanding and promoting tools to guide safe and rational reduction of PIM use among older adults. Trial registration NCT04762303, Registered February 21, 2021.

Uncontrolled allergic rhinitis during treatment and its impact on quality of life: A cluster randomized trial

2010 ◽  
Vol 126 (3) ◽  
pp. 666-668.e5 ◽  
Author(s):  
Philippe J. Bousquet ◽  
Claus Bachert ◽  
Giorgo W. Canonica ◽  
Thomas B. Casale ◽  
Joaquim Mullol ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Cluster Randomized

scholarly journals IMPACT OF WHELD INTERVENTION ON NEUROPSYCHIATRIC SYMPTOMS, ANTIPSYCHOTIC USE AND QUALITY OF LIFE IN PEOPLE WITH DEMENTIA LIVING IN NURSING HOMES: A CLUSTER-RANDOMIZED TRIAL

2017 ◽  
Vol 13 (7) ◽  
pp. P171
Author(s):  
Clive Ballard ◽  
Jane Fossey ◽  
Anne Corbett ◽  
Martin Orrell ◽  
Renee Romeo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Randomized Trial ◽  
Neuropsychiatric Symptoms ◽  
Cluster Randomized Trial ◽  
People With Dementia ◽  
Cluster Randomized

Effectiveness of a Geriatric Care Model for frail older adults in primary care: Results from a stepped wedge cluster randomized trial

2016 ◽  
Vol 28 ◽  
pp. 43-51 ◽  
Author(s):  
Emiel O. Hoogendijk ◽  
Henriëtte E. van der Horst ◽  
Peter M. van de Ven ◽  
Jos W.R. Twisk ◽  
Dorly J.H. Deeg ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Geriatric Care ◽  
Stepped Wedge ◽  
Care Model ◽  
Frail Older Adults ◽  
Cluster Randomized

scholarly journals Study to assess the effect of a structured communication approach on quality of life in secure mental health settings (Comquol): study protocol for a pilot cluster randomized trial

Trials ◽  
2013 ◽  
Vol 14 (1) ◽  
pp. 257 ◽  
Author(s):  
Douglas MacInnes ◽  
Catherine Kinane ◽  
Dominic Beer ◽  
Janet Parrott ◽  
Tom Craig ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Randomized Trial ◽  
Study Protocol ◽  
Cluster Randomized Trial ◽  
Mental Health Settings ◽  
Cluster Randomized ◽  
Communication Approach ◽  
Structured Communication

scholarly journals The Effect of Telehealth on Quality of Life and Psychological Outcomes Over a 12-Month Period in a Diabetes Cohort Within the Whole Systems Demonstrator Cluster Randomized Trial

JMIR Diabetes ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. e18 ◽  
Author(s):  
Shashivadan P Hirani ◽  
Lorna Rixon ◽  
Martin Cartwright ◽  
Michelle Beynon ◽  
Stanton P Newman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Psychological Outcomes ◽  
Cluster Randomized ◽  
Whole Systems

Cost-Effectiveness of a Chronic Care Model for Frail Older Adults in Primary Care: Economic Evaluation Alongside a Stepped-Wedge Cluster-Randomized Trial

2015 ◽  
Vol 63 (12) ◽  
pp. 2494-2504 ◽  
Author(s):  
Karen M. van Leeuwen ◽  
Judith E. Bosmans ◽  
Aaltje P. D. Jansen ◽  
Emiel O. Hoogendijk ◽  
Maaike E. Muntinga ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Cluster Randomized Trial ◽  
Stepped Wedge ◽  
Care Model ◽  
Cluster Randomized

scholarly journals Effectiveness of clinical decision support systems and telemedicine on outcomes of depression: a cluster randomized trial in general practice

2020 ◽  
Vol 37 (6) ◽  
pp. 731-737
Author(s):  
Matteo Balestrieri ◽  
Davide Sisti ◽  
Marco Rocchi ◽  
Paola Rucci ◽  
Gregory Simon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Support ◽  
Randomized Trial ◽  
Clinical Decision Support ◽  
Clinical Decision Support Systems ◽  
Cluster Randomized Trial ◽  
Clinical Decision ◽  
Medical Interview ◽  
Cluster Randomized

Abstract Background Computerized Clinical Decision Support Systems (CCDSS) are information technology tools, designed to improve clinical decision-making. Telemedicine is a health care service delivery using videoconferencing, telephone or messaging technologies. Objectives Our project aimed at testing the effectiveness of a composite CCDSS and telemedicine approach designed to treat depression in primary care. Methods This cluster randomized trial involved four GP clinics located in Northern Italy. Two clinics were assigned to the experimental protocol, and two served as controls. The study compared the telemedicine group (TG), in which GPs had access to a CCDSS platform, with the control group (CG) in which GPs provided treatment as usual (TAU). Patients scoring ≥11 on Patient Heath Questionnaire and ≥26 on the Inventory of Depressive Symptomatology-Self-Report were eligible for participation. Patients were also administered the World Health Organization Quality of Life-BREF to assess quality of life and Medical Interview Satisfaction Scale 21 to assess satisfaction with the medical interview. Results Overall, 2810 patients were screened and 66 in the experimental group and 32 in the CG passed the screening stages and met inclusion criteria. The percentage of remitters at 6 months was significantly higher in the TG than in the CG group (24.1% versus 3.1%, χ 2 = 6.6, P = 0.01). This difference remained significant after adjusting for baseline confounders. Physical and psychological quality of life improved significantly from baseline in both groups. Patients reported, on average, good satisfaction with the medical interview. Conclusions Our study showed that a combined CCDSS and telemedicine approach may be more effective than the TAU offered by GPs to patients with depression. Trial registration The trial was registered on https://clinicaltrials.gov/ on 5 October 2012 with identifier: NCT01701791. The first participant was enrolled on 5 May 2014 and the study was completed on May 2016.

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