Evidence map›Paper›PMID 26461064›Full record

Trial reportPloS one2015

Nurse-Led Medicines' Monitoring for Patients with Dementia in Care Homes: A Pragmatic Cohort Stepped Wedge Cluster Randomised Trial.

Susan Jordan, Marie Ellenor Gabe-Walters, Alan Watkins, Ioan Humphreys, Louise Newson, Sherrill Snelgrove, Michael S Dennis

2 registry-linked trialsAbstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 36 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03110471 completednot on this mapstarted 2017, after this paper: background citation

Nurse-led Medicines' Monitoring in Care Homes: a Process Evaluation of the Impact and Sustainability of the West Wales Adverse Drug Reaction (WWADR) Profile and Pharmacist Involvement

TypeobservationalSponsorSwansea UniversityRan2017 to 2018Enrolled60ConditionsDementiaArmsWest Wales Adverse Drug Reaction (WWADR) Profile, usual care
NCT04663360 nacompletednot on this mapstarted 2020, after this paper: background citation

Medication Monitoring in General Practice: Clinical Impact of Implementing a Nurse-led Adverse Drug Reaction (ADRe) Profile in Older Adults With 5 or More Prescribed Medicines

TypeinterventionalSponsorSwansea UniversityRan2020 to 2020Enrolled19ConditionsPolypharmacyArmsAdverse Drug Reaction (ADRe) Profile
3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Interventions for preventing falls in older people in care facilities.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Susan JordanCollege of Human and Health Sciences, Swansea University, Swansea, Wales.
Marie Ellenor Gabe-WaltersCollege of Human and Health Sciences, Swansea University, Swansea, Wales.
Alan WatkinsCollege of Medicine, Swansea University, Swansea, Wales.
Ioan HumphreysCollege of Human and Health Sciences, Swansea University, Swansea, Wales.
Louise NewsonCollege of Human and Health Sciences, Swansea University, Swansea, Wales.
Sherrill SnelgroveCollege of Human and Health Sciences, Swansea University, Swansea, Wales.
Michael S DennisCollege of Medicine, Swansea University, Swansea, Wales.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople with dementia are susceptible to adverse drug reactions (ADRs). However, they are not always closely monitored for potential problems relating to their medicines: structured nurse-led ADR Profiles have the potential to address this care gap. We aimed to assess the number and nature of clinical problems identified and addressed and changes in prescribing following introduction of nurse-led medicines' monitoring.

designPragmatic cohort stepped-wedge cluster Randomised Controlled Trial (RCT) of structured nurse-led medicines' monitoring versus usual care.

settingFive UK private sector care homes.

participants41 service users, taking at least one antipsychotic, antidepressant or anti-epileptic medicine.

interventionNurses completed the West Wales ADR (WWADR) Profile for Mental Health Medicines with each participant according to trial step. OUTCOMES: Problems addressed and changes in medicines prescribed. DATA COLLECTION AND ANALYSIS: Information was collected from participants' notes before randomisation and after each of five monthly trial steps. The impact of the Profile on problems found, actions taken and reduction in mental health medicines was explored in multivariate analyses, accounting for data collection step and site.

resultsFive of 10 sites and 43 of 49 service users approached participated. Profile administration increased the number of problems addressed from a mean of 6.02 [SD 2.92] to 9.86 [4.48], effect size 3.84, 95% CI 2.57-4.11, P <0.001. For example, pain was more likely to be treated (adjusted Odds Ratio [aOR] 3.84, 1.78-8.30), and more patients attended dentists and opticians (aOR 52.76 [11.80-235.90] and 5.12 [1.45-18.03] respectively). Profile use was associated with reduction in mental health medicines (aOR 4.45, 1.15-17.22).

conclusionThe WWADR Profile for Mental Health Medicines can improve the quality and safety of care, and warrants further investigation as a strategy to mitigate the known adverse effects of prescribed medicines.

trial registrationISRCTN 48133332.

Indexed as

Drug MonitoringNursesPatient CareAgedDementiaDemographyFemaleHumansMalePrescription DrugsPrescription Drugs

Identifiers

PMID26461064
PMCPMC4603896

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.