Medication optimisation Not Applicable
Conditions
Interventions
This is a large, highly pragmatic, cluster randomised controlled trial with an embedded mixed-methods process evaluation. The trial will be conducted in around 1,000 general practices in England contr
Sponsors
University of Bristol
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. General practices using EMIS or SystmOne clinical systems, and contributing to the secure data processing environment of the nationally representative Oxford-Royal College of GPs Clinical Informatics Digital Hub (ORCHID), will be eligible to participate in the trial. All patients aged =18 years who have not registered with their practice an opt-out of sharing data outside of the practice for purposes of research or planning, will be included in the main trial analysis. 2. Within the 56 practices participating in the process evaluation, all adult patients (aged =18 years) receiving a structured medication review during four 2-week blocks within the 12-month intervention period will be sent a patient-experience questionnaire, and all adult patients receiving a review within the 12-month intervention period will be sent a quality of life questionnaire. Additionally, a smaller number of patients will be approached and invited to provide consent to participate in an interview.
Exclusion criteria
Exclusion criteria: 1. Patients aged 17 years and under 2. Patients who have registered with their practice an opt-out of sharing data outside of the practice for purposes of research or planning
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Potentially inappropriate prescribing (PIP) at 12 months will be assessed using routine electronic health records. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Number of long-term medicines currently used at 12 months, captured via routine electronic health records 2. Medication Treatment Burden at 12 months, measured using Multimorbidity treatment burden questionnaire (MTBQ) 3. Medication Regimen Complexity Index at 12 months, captured via routine electronic health records 4. Medication adherence at 12 months, captured via routine electronic health records 5. Quality of life at 3 months post-review, measured using the EQ5D-5L 6. Rates of medication review at 12 months, assessed via routine electronic health records 7. Health service utilisation including GP consultations and unplanned hospitalisation over the past 12 months, captured via routine electronic health records and Hospital Episode Statistics (national administrative records) 8. All cause mortality at 12 months captured via routine electronic health records and Hospital Episode Statistics (national administrative records) 9. NHS costs (i.e. sum of GP prescribing, consultations, and hospital use) assessed using routine electronic health records and Hospital Episode Statistics (national administrative records) at 12 months | — |
Countries
England, United Kingdom
Contacts
Public ContactDeborah McCahon
Outcome results
None listed