Patient-centred Deprescribing of Psychotropic, Sedative and Anticholinergic Medication in Elderly Patients With Polypharmacy
Patient-centred Deprescribing of Psychotropic, Sedative and Anticholinergic Medication in Elderly Patients With Polypharmacy: a Cluster-randomised Trial
Ludwig-Maximilians - University of Munich
352 participants
Mar 25, 2023
INTERVENTIONAL
Conditions
Summary
The PARTNER study is a multicentre, two-arm, pragmatic cluster-randomised trial evaluating the impact of a focused and patient-centred cooperation between general practitioners (GPs) and community pharmacists (PARTNER intervention) on reductions in the use of psychotropic, sedative and anticholinergic potentially inappropriate medication (PSA-PIM) compared to a control intervention. The PARTNER intervention comprises (1) education for health care professionals, (2) an interprofessional workshop and case conference, (3) a pharmacy visit with brown bag/medication review and patient empowerment, (4) GP practice visit with shared decision making. The control intervention only comprises a pharmacy visit with brown bag review.
Eligibility
Inclusion Criteria6
- Aged 65 years or older
- Patient is capable of giving consent
- GP contact in the quarter prior to inclusion
- Current use of ≥ 5 drugs, including ≥ 1 PSA-PIM (hypnotics, opioids, gabapentinoids, antipsychotics, antidepressants, anticholinergic urospasmolytics) with a treatment duration of ≥ 6 months
- Willingness to select a regular pharmacy for the study period
- Consent to data exchange between GP and community pharmacy
Exclusion Criteria6
- Terminal illness (life expectancy \< 6 months)
- Current treatment of pain associated with cancer
- Other serious physical illness or mental distress (e.g. bereavement) that makes participation in the study impossible (according to the GP's assessment)
- Psychiatric illness or addiction that makes participation in the study impossible (according to the GP's assessment)
- Unable to meet the requirements of the study (participation in telephone or written questionnaires, visits to the GP practice or community pharmacy, alone or with the help of caregivers for physical infirmity)
- Current participation in research projects on medication safety or geriatric medicine
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Interventions
The PARTNER intervention includes the following components: 1. Education for health care professionals A) written manual on deprescribing PSA-PIM, which consists of brief information and more detailed explanations; B) access to digital instructional videos/podcasts that address potential problems in deprescribing and provide possible solutions; C) checklist for identification of drug-related problems for pharmacists; D) tapering support tool to facilitate the selection of tapering schemes; E) divisibility list for PSA-PIM to support the implementation of tapering schemes; F) empowerment brochures for patients each focussing on one PSA-PIM subgroup 2. Interprofessional workshop and case conference for GPs and pharmacists 3. Pharmacy visit (brown bag/medication review) including patient empowerment 4. GP practice visit including shared decision making (SDM)
The control intervention only comprises a pharmacy visit with brown bag review.
Locations(3)
View Full Details on ClinicalTrials.gov
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NCT05842928