The Prevention of Polypharmacy in Primary Care Patients Trial (4P-RCT)

Conditions

Polypharmacy Not Applicable

Zechmann S, Senn O, Valeri F, Essig S, Merlo C, Rosemann T, Neuner-Jehle S.

2020-11-1637 citations

Barriers and enablers for deprescribing among older, multimorbid patients with polypharmacy: an explorative study from Switzerland

Stefan Zechmann, Cosima Trueb, Fabio Valeri, Sven Streit, Oliver Senn et al. (6 authors)

BMC Family Practice2019-05-1447 citations

10.1186/s12875-019-0953-4

Effect of a patient-centered drug review on polypharmacy in primary care patients: study protocol for a cluster-randomized controlled trial

Susann Hasler, Oliver Senn, Thomas Rosemann, Stefan Neuner‐Jehle

Trials2015-08-2522 citations

10.1186/s13063-015-0915-7

Interventions

1. Practices in the control group: The control group is given a lecture on multimorbidity and instructions for collecting data in a usual care activity 2. Practices in the intervention

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Aged at least 60 years and capable of judgement 2. Taking five or more medicaments in the long term (six months or longer)

Exclusion criteria

Exclusion criteria: Life expectancy less than 12 months

Design outcomes

Primary

Measure	Time frame
Change in the number of drugs (deprescribing rate) 12 months after applying the deprescribing tool.	—

Secondary

Measure	Time frame
1. Change in the number of drugs immediately after the encounter and six months later 2. Reason for a change, categorized in the four options of the algorithm, number of drugs in each category 3. Discrepancy in the decision to quit, change or continue the drug between doctor and patient 4. Number of drugs the patient is taking not known to the doctor 5. Time consumption of the intervention 6. Disease-specific variables to evaluate the course of the disease(s) which the patient is treated for, including hospitalization and unexpected adverse event rates. Measurement will be performed by biometric analysis (e.g. blood pressure monitoring, serum glucose) and validated disease specific scores (e.g. pain, depression) 7. Number of drugs readopted due to an unfavorable course of the disease(s) (readoption rate) 8. Change in quality of life after 12 months, measured by a standardized short form questionnaire (EQ-5D) and a single Likert-scale item 9. Barriers perceived by patients against the approach / algorithm After the baseline assessment (including socioeconomic variables) systematic follow-up measurements will take place after six and 12 months.	—

Measure

Time frame

1. Change in the number of drugs immediately after the encounter and six months later 2. Reason for a change, categorized in the four options of the algorithm, number of drugs in each category 3. Discrepancy in the decision to quit, change or continue the drug between doctor and patient 4. Number of drugs the patient is taking not known to the doctor 5. Time consumption of the intervention 6. Disease-specific variables to evaluate the course of the disease(s) which the patient is treated for, including hospitalization and unexpected adverse event rates. Measurement will be performed by biometric analysis (e.g. blood pressure monitoring, serum glucose) and validated disease specific scores (e.g. pain, depression) 7. Number of drugs readopted due to an unfavorable course of the disease(s) (readoption rate) 8. Change in quality of life after 12 months, measured by a standardized short form questionnaire (EQ-5D) and a single Likert-scale item 9. Barriers perceived by patients against the approach / algorithm After the baseline assessment (including socioeconomic variables) systematic follow-up measurements will take place after six and 12 months.

—

Countries

Switzerland

Outcome results

None listed