Research projects to focus on elderly patients receiving medical treatment

Professor Christian Backer Mogensen, consultant, PhD, Focused Research Unit in Emergency Medicine, University of Southern Denmark (SDU) (DKK 586,000)

The risk of drug interaction increases with the number of medicines, but also because of the increased sensitivity of elderly patients to drug interactions. Elderly patients who have been discharged from hospital are at particular risk, as most patients will find that several changes are made to their medication. Therefore, discharges from the hospital as well as other sector transitions are critical elements in a course of treatment, with the risk of knowledge loss, misunderstandings and patient safety incidents.
Despite the fact that information on medicines is sent from the hospital to the elderly person’s own general practitioner (GP), and that health professionals can access the Joint Medicine Card (Fælles Medicinkort (FMK)), which is designed to improve cooperation and safety as regards incorrect medication, it is not possible for all the different parties involved in the treatment process to exchange information. Thus, it is therefore necessary to develop one or more tools for reviewing and reorganising medication which can be used together by several parties.
The purpose of this project is therefore, together with patients, caregivers and healthcare professionals, to develop a method whereby the patient can receive exactly the right medication following discharge from hospital. The project will examine the needs, wishes and barriers among the various stakeholders, and together with patients, caregivers, doctors, pharmacists and home-helpers is seeking to develop a solution which can be further developed, adapted and tested. The project will be carried out under the auspices of the research programme ‘PÅ FORKANT’ (At the forefront), which is a collaboration between hospitals, municipalities and GPs in the municipalities in question, as well as universities. In addition, there are four users in the project steering group.

Associate professor Maria Skaalum Petersen, Department of Occupational Medicine and Public Health, National Hospital of the Faroe Islands (DKK 1,218,602)

Worldwide, the elderly account for a larger proportion of the population, with those aged 90 years and over being the fastest growing group. Growing older is often accompanied by polypharmacy – the use of five or more types of medication – but this can be harmful if inappropriate drug interactions occur as well as side-effects, despite the fact that each preparation on its own is a correct treatment.
Little is known about medicine consumption among elderly Faroese, or about the prevalence of inappropriate medication, but the use of an integrated electronic health record system across different sectors combined with the small and homogenous population results, according to the researchers’ hypothesis, in fewer challenges in connection with medicine use by the elderly.
The aim of the project is therefore to examine medicine consumption among elderly Faroese and to contribute to more appropriate medication and sector transition for frail elderly patients. The project will examine attitudes towards medicine consumption among elderly aged 90 years and over through qualitative and quantitative methods, including home visits. The project will also examine attitudes towards medication among doctors in connection with discharging elderly patients from hospital.
The project is being carried out through a cooperation between universities, hospitals, associations and local authorities, while also collaborating with Professor Kaare Christensen from the University of Southern Denmark (SDU).

Senior researcher Anne Estrup Olsen, Clinical Pharmacology Unit, Aalborg University Hospital (DKK 1,983,222)

Patient safety incidents are the most frequently reported type of adverse incident in the health care system, and elderly people receiving municipal care are at particular risk. Studies have shown that there is a link between the patient safety culture among staff and actual patient safety.
However, studies of patient safety culture are limited by the fact that they are primarily based on foreign observational studies without control groups. It is therefore necessary to design and test new interdisciplinary and intersectoral interventions in randomised trials with a view to reducing the risk of patient safety incidents.
The aim of the PhD project is therefore to develop and test an intervention which can improve patient safety culture when medically treating weak elderly people which could potentially be rolled out in practice. In addition, studies will be carried out to establish whether the intervention has a clinical and health economic effect. Data will be collected before, during and after the intervention through interviews, questionnaires and registers. The intervention is being developed by an intersectoral and interdisciplinary panel comprising staff, citizens, caregivers and GPs, so the project therefore has a high level of user involvement.
The project will be carried out in cooperation with the Clinical Pharmacology Department at Aalborg University Hospital, Aalborg University, University College of Northern Denmark (UCN), GPs and the Municipality of Aalborg.