RecruitingNot ApplicableNCT05526963

Reduction of Polypharmacy in Elderly People With Multiple Diseases

Reduction of Polypharmacy in Elderly People With Multiple Diseases - a Stepped Wedge Cluster-randomized Controlled Trial

Sponsor

Martin-Luther-Universität Halle-Wittenberg

Enrollment

1,146 participants

Start Date

May 30, 2024

Study Type

INTERVENTIONAL

Conditions

Polypharmacy Multimorbidity

Summary

Elderly GP patients are often treated with five or more medications and therefore prone to adverse drug reactions (ADR). Potentially inappropriate prescriptions (PIPs) lead to increased adverse events like falls, hospitalizations and mortality. The primary aim of this study to reduce the frequency of ADRs in multimorbid patients aged 70 years and older by reducing polypharmacy.

Eligibility

Min Age: 70 Years

Inclusion Criteria3

≥ 5 longterm medications (\> 6 months) (polypharmacy)
≥ 3 chronic diseases (multimorbidity)
≥ 1 family doctor consultation within the last 6 months

Exclusion Criteria6

Patients with a critically reduced life expectancy
Patients who cannot autonomously visit the family practice
Patients who cannot participate in the informed consent process
Patients who are residing in a nursing home
Patients with dementia or a mental of behavioral disorder ICD-10 F00-F99
Patients who are participating in another medical study with a focus on polypharmacy or multimorbidity

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Interventions

OTHERMedication plan review

Intervention group patients will receive a revised medication plan by external pharmacologist based on the the STOPP/START criteria. The revised medication plan will be provided to the family physician who then will provide it to the patient. The revision comes along with evidence based information for the physician to prevent possible uncertainties by the physicians.

BEHAVIORALAdherence support

Intervention group patients will receive a study nurse administered adherence support measure based on telephone-based motivational interviewing. The measure includes information on possible consequences of inadherence and signs of adverse drug reactions that is comprehensible for lay persons.