Callegari Enrico, Benth Jurate Šaltytė, Selbæk Geir, Grønnerød Cato, Bergh Sverre
Østfold Hospital Trust, 1714 Grålum, Norway.
Faculty of Medicine, University of Oslo, 0372 Oslo, Norway.
Pharmacy (Basel). 2022 Feb 16;10(1):32. doi: 10.3390/pharmacy10010032.
The effect of the Norwegian General Practice-Nursing Home (NorGeP-NH) criteria has never been tested on clinical outcomes in nursing home (NH) residents. We performed a cluster-randomized trial in Norwegian NHs and tested the effect of NorGeP-NH on QoL (primary outcome), medication prescriptions, and physical and mental health (secondary outcomes) for the enrolled residents; Methods: Fourteen NHs were randomized into intervention NHs (iNHs) and control NHs (cNHs). After baseline data collection, physicians performed NorGeP-NH on the enrolled residents. We assessed the difference between cNHs and iNHs in the change in primary outcome from baseline to 12 weeks and secondary outcomes from baseline to eight and 12 weeks by linear mixed models; Results: One hundred and eight residents (13 lost to follow-up) and 109 residents (nine lost to follow-up) were randomized to iNHs and cNHs, respectively. Difference in change in QoL at 12 weeks between cNHs and iNHs was not statistically significant (mean (95% CI)): -1.51 (-3.30; 0.28), = 0.101). We found no significant change in drug prescriptions over time. Difference in depression scores between cNHs and iNHs was statistically significant after 12 weeks.
Our intervention did not affect QoL or drug prescriptions, but reduced depression scores in the iNHs. NorGeP-NH may be a useful tool, but its effect on clinical outcomes may be scarce in NH residents. Further studies about the effectiveness of NorGeP-NH in other healthcare contexts and settings are recommended.
挪威全科医疗-养老院(NorGeP-NH)标准对养老院(NH)居民临床结局的影响从未得到过验证。我们在挪威的养老院开展了一项整群随机试验,测试NorGeP-NH对纳入居民的生活质量(主要结局)、药物处方以及身心健康(次要结局)的影响;方法:14家养老院被随机分为干预养老院(iNHs)和对照养老院(cNHs)。在收集基线数据后,医生对纳入居民实施NorGeP-NH。我们通过线性混合模型评估了cNHs和iNHs在从基线到12周的主要结局变化以及从基线到8周和12周的次要结局变化方面的差异;结果:分别有108名居民(13名失访)和109名居民(9名失访)被随机分配到iNHs和cNHs。cNHs和iNHs在12周时生活质量变化的差异无统计学意义(均值(95%CI)):-1.51(-3.30;0.28),P = 0.101)。我们发现随着时间推移药物处方无显著变化。cNHs和iNHs在12周后的抑郁评分差异有统计学意义。
我们的干预未影响生活质量或药物处方,但降低了iNHs居民的抑郁评分。NorGeP-NH可能是一个有用的工具,但其对养老院居民临床结局的影响可能有限。建议进一步研究NorGeP-NH在其他医疗环境和场景中的有效性。