Polypharmacy, multimorbidity Not Applicable
Conditions
Interventions
The intervention will involve a pharmacist integrating into the GP practice where they will support prescribing-related activities. The first component of the intervention will be the medicines optimi
Sponsors
Royal College of Surgeons in Ireland
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: GP practices: 1. Over 500 patients aged =65 years on patient panel Patients: 1. = 65 years of age 2. Complex polypharmacy (defined as =10 repeat medications) 3. Living in the community 4. Ability to attend GP practice for medication review with the pharmacist
Exclusion criteria
Exclusion criteria: GP practices: 1. Practices will be excluded if they have <500 older patients Patients: 1. Under the age of 65 2. Terminally ill leading to death or major disability during study follow-up period 3. Severe cognitive impairment psychiatric/psychological morbidity sufficient to impair informed consent provision 4. Resident in nursing home 5. Currently participating in a related study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Mean PIPs per patient, measured at baseline and 4 months | — |
Secondary
| Measure | Time frame |
|---|---|
| Measured at baseline and 4 months: 1. Medication-related outcomes, measured through medical review: 1.1 Number of repeat medications each patient is regularly taking as per patient medication record (PMR) 1.2 Proportion of patients with polypharmacy (= 10 regular medications) as determined from study data 1.3 Medication changes: 1.3.1. Deprescribing measured by reported study data 1.3.2. Medications started measured by reported study data 1.3.3. Number of medications prescribed generically measured by recorded information on PMR 1.3.4. ADRs leading to drug withdrawal measured by reported study data 2. Patient-reported outcome measures: 2.1 Health-related quality of life measured by the EQ5D-5L 2.2 Patients' beliefs and attitudes towards deprescribing measured by the Patients Attitudes Towards Deprescribing (PATD) questionnaire 2.3 Burden of treatment measured by Multimorbidity Burden of Treatment Questionnaire 2.4 Patients' beliefs about the necessity of medicines and concerns measured by the Patients’ Beliefs about Medicines Questionnaire 3. Role and impact of pharmacist, measured throughout intervention by the means of a research pharmacist maintained 'Pharmacist Activity Log': 3.1. Activities undertaken 3.2. Condition-specific domains 3.3. Engagement with other healthcare professionals and practice staff 3.3.1. GPs 3.3.2. Community pharmacists 3.3.3. Hospital staff 3.3.4. Practice staff 3.3.5. Other healthcare professionals | — |
Countries
Ireland
Contacts
Public ContactAisling Croke
Outcome results
None listed