PRIMA-eDS: Polypharmacy in chronic diseases: Reduction of Inappropriate Medication and Adverse drug events in elderly populations by electronic Decision Support

Conditions

Multimorbid older patients in primary care Signs and Symptoms

Anja Rieckert, David Reeves, Attila Altiner, Eva Drewelow, Aneez Esmail et al. (17 authors)

BMJ2020-06-18136 citations

Polypharmacy in older patients with chronic diseases: a cross-sectional analysis of factors associated with excessive polypharmacy.

Rieckert A, Trampisch US, Klaaßen-Mielke R, Drewelow E, Esmail A, Johansson T, Keller S, Kunnamo I, Löffler C, Mäkinen J, Piccoliori G, Vögele A, Sönnichsen A.

2018-07-1883 citations

10.1186/s12875-018-0795-5

Polypharmacy in chronic diseases-Reduction of Inappropriate Medication and Adverse drug events in older populations by electronic Decision Support (PRIMA-eDS): study protocol for a randomized controlled trial.

Sönnichsen A, Trampisch US, Rieckert A, Piccoliori G, Vögele A, Flamm M, Johansson T, Esmail A, Reeves D, Löffler C, Höck J, Klaassen-Mielke R, Trampisch HJ, Kunnamo I.

2016-01-2960 citations

10.1186/s13063-016-1177-8

Interventions

The PRIMA-eDS tool will only be available in the intervention group and not in the control group. The GP in the intervention group uses the PRIMA-eDS tool at each follow up visit (study visits are sch

Study Entry: Single Randomisation only

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Age of 75 years and above living in the community or in a nursing home 2. At least 8 continuous drug prescriptions 3. Willing to participate 4. Able to sign informed consent according to the declaration of Helsinki

Exclusion criteria

Exclusion criteria: 1. Patients with a life expectancy assumed to be less than 1 year, e.g. patients with advanced cancer 2. Patients receiving chemotherapy and/or therapeutic radiation 3. Patients with dementia who are unable to provide informed consent

Design outcomes

Primary

Measure	Time frame
Composite of first hospitalization and death measured at 24 months	—

Secondary

Measure	Time frame
Current secondary outcome measures as of 25/08/2015: 1. All cause mortality 2. Hospital admission (number of episodes and duration) 3. Falls 4. Fractures 5. Quality of life 6. The number and types of drugs discontinued 7. The number and types of drugs not discontinued despite the recommendation to discontinue 8. The number and types of drugs re-administered for symptom control 9. Medication costs 10. Adverse event rate All measured at baseline, 8, 16, and 24 months. Previous secondary outcome measures: 1. All cause mortality 2. Hospital admission (number of episodes and duration) 3. Falls 4. Fractures 5. Quality of life 6. The number and types of drugs discontinued 7. The number and types of drugs not discontinued despite the recommendation to discontinue 8. The number and types of drugs re-administered for symptom control 9. Medication and health care costs All measured at baseline, 8, 16, and 24 months.	—

Measure

Time frame

Current secondary outcome measures as of 25/08/2015: 1. All cause mortality 2. Hospital admission (number of episodes and duration) 3. Falls 4. Fractures 5. Quality of life 6. The number and types of drugs discontinued 7. The number and types of drugs not discontinued despite the recommendation to discontinue 8. The number and types of drugs re-administered for symptom control 9. Medication costs 10. Adverse event rate All measured at baseline, 8, 16, and 24 months. Previous secondary outcome measures: 1. All cause mortality 2. Hospital admission (number of episodes and duration) 3. Falls 4. Fractures 5. Quality of life 6. The number and types of drugs discontinued 7. The number and types of drugs not discontinued despite the recommendation to discontinue 8. The number and types of drugs re-administered for symptom control 9. Medication and health care costs All measured at baseline, 8, 16, and 24 months.

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Countries

Austria, Germany, Italy, United Kingdom

Outcome results

None listed