NCT01171339

Prioritising and Optimising Multi-medication in Multimorbidity

Prioritising and Optimising Multiple Medications in Elderly Multimorbid Patients in General Practice. - A Pragmatic Cluster-randomised Controlled Trial.

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 505 (actual)
• Sponsor: Goethe University · Academic / Other
• Sex: All
• Age: 60 Years
• Healthy volunteers: Not accepted

Summary

Objective: To investigate whether the complex intervention will improve the appropriateness of prescriptions in elderly multi-morbid patients with multi-medication in general practices. Study hypothesis: The primary objective of the study is to determine whether the complex intervention will improve the appropriateness of prescriptions compared to usual care. The primary efficacy endpoint is the change in the Medication Appropriateness Index (MAI) score from baseline (T0) to 6 months after baseline (T1), i.e. the difference MAI T1-T0.

Detailed description

Key elements (1 to 4) of the complex intervention: 1. Basic assessment of medicines that were actually taken (brown bag review) by a general practice based health care assistant (HCA) and 2. Checklist-based (MediMoL - Medication-Monitoring-List) pre-consultation interview on problems relating to medicines (technical handling, potential adverse drug reactions) and patient's therapeutic aims by HCA provides structured information in the Medication-Monitoring-List (MediMoL) for the general practitioner (GP) and enables patients to discuss their problems with the GP. 3. GP uses a computerized decision support system (pharmaceutical information system, AiD+) to optimize medication (reducing number of inappropriate prescriptions, e.g. pharmaceutical interactions, renal dose adjustments, duplicate prescriptions) and 4. prioritizes medication in the physician-patient consultation taking into consideration patient's preferences.

Conditions

• Chronic Disease

Interventions

Type	Name	Description
OTHER	Optimization strategy (complex intervention)	Healthcare assistant (HCA) and computer assisted optimization of multi-medication (complex intervention) in accordance with recommended standard# #Recommended standard: clinical practice guideline "Geriatrie" of the guideline group of Hesse (part 1 and 2)

Timeline

• Start date: 2010-08-01
• Primary completion: 2012-02-29
• Completion: 2012-02-29
• First posted: 2010-07-28
• Last updated: 2017-10-31

Locations

1 site across 1 country: Germany