Forte grants to Kristina Johnell and Johan Fastbom

24 November, 2014 in subject Okategoriserade

We proudly present and congratulate Kristina Johnell and Johan Fastbom for approved grants from Forte, the Swedish Research Council for Health, Working Life and Welfare. See below descriptions of the projects:
Kristina Johnell: Drug Prescribing in End-Of-Life care in nursing homes (PEOL project): improved treatment across countries
Appropriate and well-balanced drug treatment in old age is essential for the well-being of older persons. However, there is a lack of studies about appropriate drug treatment for elderly people in end-of-life care. This special situation of drug prescribing calls for a totally different way of thinking – drugs that are usually regarded as appropriate may be inappropriate in palliative care and vice versa.
This interdisciplinary project aims to assess and improve the quality of drug prescribing for nursing home residents during the last months before death by developing quality indicators and through analyses of Swedish register data of nursing home residents and The French National Insurance Healthcare database.
We aim to 1) develop quality indicators for drug treatment in end-of-life care in the nursing home setting; 2) use the quality indicators to compare inappropriate and appropriate drug treatment in end-of-life care in Sweden and France; and 3) examine the association between the quality indicators and unplanned hospital admissions in the last 6 months of life.
Our findings will be implemented in health care and social care through updates of already existing indicators for drug therapy in older persons, decision support systems for both health care professionals and users and their relatives and in continued education in health care and social care and to Patients and Seniors Associations.
The project will provide an unprecedented insight into the quality of prescribing in the last months of life of nursing home residents, based on new quality indicators for drug prescribing, large-scale data and cross-country comparisons. Hence, this project has great potential for improving the care and well-being of frail older people at end-of-Life.
Johan Fastbom: Patient-centered IT-support for Quality and Safety of drug use in the elderly: The QS-project
Drug use in the elderly is extensive and increasingly complex. Drug related problems are common and one of the more serious consequences is that at least 10% of hospital admissions of old people are due to adverse drug reactions. Bringing down drug related illness in the elderly would have profound effects both in terms of health and economy.
In this project we aim to investigate how a freely available web based drug information and support system for elderly (SeniorminiQ), and a tool for assessing risks for unsafe drug use (Safe Medication Assessment, SMA), may be used together, to improve drug use in the elderly. In SeniorminiQ the elderly or a relative can enter information about actual drug use and symtoms and generate a printout with relevant questions on the appropriateness of the drug use, which may be brought to the doctor’s call. We will examine the patient’s and physician’s opinions about the benefits of this procedure and measure it’s effects on the quality of drug use. Further, we will investigate how SeniorminiQ in combination with a computerised version of SMA, can be employed by district nurses in preventive home visits (“hälsosamtal”) to 75 year old persons, and if this may be an efficient and sensitive tool to detect drug related problems. Finally, we will study whether the quality analysis in SeniorminiQ together with the safety assessment in SMA, can be used to signal a need of a drug utlisation review, and explore the possibility for the physician to open the “case” in the professional version of miniQ, to make a drug utilisation review.
The relevance of this project is that it introduces a model that stimulates the patient’s involvement in her/his drug treatment and allows the physician to take responsibility and involve the patient in optimising the quality and safety of drug treatment, with due support from the nurse.