Improving Medication Prescription in the contExt of advance care planning for paTients receiving long term nUrSing home care (IMPETUS) (WC2016-061)

Background

Starting date: 01/09/2016

Nursing home (NH) residents often have a limited life expectancy (1.5-2.5 years). Many suffer the combined burden of advanced disease, functional impairment and severe dependency. The trend to postpone NH admission has resulted in patients having a more advanced stage of their disease and consequently a shorter time of survival following admission.

These patients often use a large number of drugs. Consequently, they often suffer from a heavy treatment burden, not seldom accompanied by under treatment of pain and other symptoms of discomfort. It is increasingly recognized that prescribing in this patient group is better guided by a geriatric palliative care (GPC) approach, with focus on quality of life, comfort and medication safety rather than on disease-specific outcomes and life extension. Due to various reasons, however, this appears not to happen in practice.

This project is a collaboration between two academic centers: the Vumc and UMCG, and also the EMGO Institute for Health and Care Research (EMGO+)