Cargill 1992.
| Study characteristics | ||
| Methods |
Aim of study: to provide information on identification of patients at highest risk for problems related to medication non‐compliance and problematic behaviours in the home setting and their response to teaching interventions; to optimise medication‐taking compliance of elderly patients by strengthening the home medication administration system; to reinforce the nursing role as facilitator of maximum health status Study design: RCT (unit of allocation: individual) Number of arms/groups: 3 |
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| Participants |
Description: both patient/consumer and carer Geographic location: USA Setting: outpatient clinic (general medicine servicing Veterans Administration) Inclusion criteria: ≥ 60 years, metropolitan area accessible to home visits Number of participants randomised: 70 Number of participants included in analysis: 70 Age: range 62 to 97 years, mean 72 Gender: not specified Ethnicity: not specified Number of medications: prescription, non‐topical, non‐inhalant, non‐liquid; mean: 7.5 Frailty/Functional impairment: not specified Cognitive impairment: not specified Comorbidities: not specified |
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| Interventions |
Group 2 ‐ Nurse teaching session: 20‐minute teaching session, including review of medications timed to patient's schedule and any allowed flexibility. A pill cassette was dispensed if feasible for the patient Group 3 ‐ Nurse teaching session and follow‐up phone call: 20‐minute teaching session (as above) plus additional follow‐up telephone call 1 to 2 weeks after visit in which the nurse reviewed the medication regimen verbally with the patient Group 1‐ Usual care Co‐intervention: N/A Provider: nurse Where: home ± phone call (group 3) When and how often: once (+ follow‐up at 1 to 2 weeks in group 3) Intervention personalised: personalised review of medications was timed to patient's schedule; pill cassette was dispensed if feasible |
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| Outcomes |
Timing of outcome assessment: baseline, 4 to 6 weeks Medication adherence (objective): pill count percentage compliance. Percentage of pills taken vs those prescribed to be taken using pill count Medication taking ability (objective): behaviour score/100 for congruency between supply of medications on hand and prescribed medications (/40), verbalising correct regimen (/30), maintaining each prescribed med (/20), appropriate use of OTC (/10). Points deducted for sequestering old scripts, using alternative medications inappropriately, or mixing medications together |
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| Notes | Trial registration: N/A Consumer involvement: not specified Funding source: not specified Dropout: N/A |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Not specified |
| Allocation concealment (selection bias) | Unclear risk | Not specified |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | No mention of blinding; assume patients and nurses knew allocation to perform intervention |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | No mention of blinding |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | No mention of attrition |
| Selective reporting (reporting bias) | Unclear risk | Raw data not reported; only in graph format |
| Other bias | Low risk | None apparent |