The IMMENSE study
The IMMENSE trial (A new interdisciplinary collaboration structure in secondary and primary care to improve medication safety in the elderly) was a randomized controlled trial run including patients from September 2016 - December 2019. Analyses has been ongoing until May 2025. Three PhD students, one postdoctoral and eight master students in pharmacy have been working with the study data or study-related data.
The primary objective of the IMMENSE study was to explore whether a new inter-professional collaboration structure between hospital physician, pharmacists and GPs focusing on medications applying the Integrated medicines management (IMM) methodology would reduce emergency medical visits (acute hospitalizations and visits to the emergency departments) for elderly patient admitted to a geriatric ward or a general internal medicines ward.
Secondary outcomes included time to first hospitalization, length of hospital stay (LOS), mortality rate, differences in hip fractures, strokes, medications, and differences in self-reported quality of life, and medication appropriateness in-between the two study groups.
No significant difference between the study groups were identified related to the primary and secondary endpoints. However, pharmacists were well included in the interdisicplinary team, delivered the intervention elements in a high degree, and identified many drug-related problems that were solved. The health-economic study concluded with the following: "According to societal willingness-to-pay thresholds, the medication optimization intervention was not cost effective compared to standard care for the full population. The intervention dominated standard care for the non-long stayers, with a high probability of cost effectiveness".
Publications out:
8: Robinson EG, Gyllensten H, Johansen JS, Havnes K, Granas AG, Bergmo TS, Småbrekke L, Garcia BH, Halvorsen KH. A Trial-Based Cost-Utility Analysis of a Medication Optimization Intervention Versus Standard Care in Older Adults. Drugs Aging. 2023 Dec;40(12):1143-1155. doi: 10.1007/s40266-023-01077-7. Epub 2023 Nov 22. PMID: 37991657; PMCID: PMC10682290.
7: Havnes K, Svendsen K, Johansen JS, Granas AG, Garcia BH, Halvorsen KH. Is anticholinergic and sedative drug burden associated with postdischarge institutionalization in community-dwelling older patients acutely admitted to hospital? A Norwegian registry-based study. Pharmacoepidemiol Drug Saf. 2023 Jun;32(6):607-616. doi: 10.1002/pds.5590. Epub 2023 Jan 10. PMID: 36585814.
6: Robinson EG, Gyllensten H, Granas AG, Halvorsen KH, Garcia BH. Health-related quality of life among older adults following acute hospitalization: longitudinal analysis of a randomized controlled trial. Qual Life Res. 2024 Aug;33(8):2219-2233. doi: 10.1007/s11136-024-03689-x. Epub 2024 Jun 17. PMID: 38884880; PMCID: PMC11286627.
5: Havnes K, Lehnbom EC, Walter SR, Garcia BH, Halvorsen KH. Time distribution for pharmacists conducting a randomized controlled trial-An observational time and motion study. PLoS One. 2021 Apr 30;16(4):e0250898. doi: 10.1371/journal.pone.0250898. PMID: 33930091; PMCID: PMC8087006.
4: Johansen JS, Halvorsen KH, Svendsen K, Havnes K, Robinson EG, Wetting HL, Haustreis S, Småbrekke L, Kamycheva E, Garcia BH. Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (The IMMENSE study) - a randomized controlled trial. BMC Health Serv Res. 2022 Oct 26;22(1):1290. doi: 10.1186/s12913-022-08648-1. PMID: 36289541; PMCID: PMC9597977.
3: Johansen JS, Halvorsen KH, Havnes K, Wetting HL, Svendsen K, Garcia BH. Intervention fidelity and process outcomes of the IMMENSE study, a pharmacist-led interdisciplinary intervention to improve medication safety in older hospitalized patients. J Clin Pharm Ther. 2022 May;47(5):619-627. doi: 10.1111/jcpt.13581. Epub 2021 Dec 21. PMID: 34931699.
2: Johansen JS, Halvorsen KH, Svendsen K, Havnes K, Garcia BH. The impact of hospitalisation to geriatric wards on the use of medications and potentially inappropriate medications - a health register study. BMC Geriatr. 2020 Jun 1;20(1):190. doi: 10.1186/s12877-020-01585-w. PMID: 32487225; PMCID: PMC7268415.
1: Johansen JS, Havnes K, Halvorsen KH, Haustreis S, Skaue LW, Kamycheva E, Mathiesen L, Viktil KK, Granås AG, Garcia BH. Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomised controlled trial. BMJ Open. 2018 Jan 23;8(1):e020106. doi: 10.1136/bmjopen-2017-020106. PMID: 29362276; PMCID: PMC5786089.
Members:
Financial/grant information:
The IMMENSE trial was funded by Helse Nord RHF and the Department of Pharmacy, UiT.