• Ulrike Junius-Walker, Olaf Krause, Petra Thürmann, Simone Bernhard, Angela Fuchs, Lisa Sparenberg, Anja Wollny, Regina Stolz, Hannah Haumann, Antje Freytag, Claudia Kirsch, Svetlana Usacheva, Stefan Wilm, and Birgitt Wiese.
• Institute for General Practice, Hannover Medical School; Medical Rehabilitation and Geriatrics, Hospital DIAKOVERE Henriettenstift, Hannover; Philipp Klee Institute for Clinical Pharmacology, University of Witten/Herdecke, Wuppertal; Institute for General Practice, Heinrich-Heine University Düsseldorf; Institute of General Practice, Rostock University Medical Center; Institute for General Medicine and Inter professional Care, Tübingen University Hospital; Institute of General Practice and Family Medicine, Jena University Hospital.
• Dtsch Arztebl Int. 2021 Oct 22; 118 (42): 705-712.

BackgroundThe safety of drug use by nursing-home residents can be impaired by polypharmacy, potentially inappropriate medications (PIM), and neuroleptics, as well as by a lack of adequate interprofessional coordination in the nursing home. The goal of the HIOPP-3-iTBX Trial was to improve drug safety in nursing-home residents, including a reduction of PIM and/or neu - roleptic use, by means of a complex interprofessional intervention.MethodsThis cluster-randomized, controlled trial was performed in nursing homes in Germany. Residents over age 65 were included in the trial. The intervention was carried out over six months and consisted of four elements: a drug review by trained pharmacists, educational sessions for general practitioners and nurses, a drug safety toolbox, and change management seminars for members of the three participating professions. The nursing homes in the control group continued to provide usual care. The primary endpoint was the prescription of at least one PIM and/or at least two neuroleptic drugs simultaneously. The secondary endpoints were the incidence of falls and hospitalizations, quality of life, and health-care costs. This trial is registered in the German Clinical Trials Registry (DRKS00013588).Results44 nursing homes with 862 residents were randomized, 23 of them (with 452 residents) to the intervention group and 21 (with 410 residents) to the control group. 41% of all nursing-home residents initially took at least one PIM and/or at least two neuroleptic drugs simultaneously. Follow-up data (including, among other things, the current drug regimen) were obtained for 773 residents. The intention-to-treat analysis continued to show no difference between the intervention group and the control group with respect to the primary endpoint.ConclusionThis trial of an intervention to improve drug safety in nursing homes led neither to reduced prescribing of PIM and/or neuroleptic drugs, nor to any improvement in the overall health status of the nursing-home residents.

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