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Objective: To evaluate the clinical and economic impact of the application of an algorithm to improve the adequacy and safety of pharmacotherapy in elderly polymedicated (receiving 8 or more medications), not institutionalized.
Design: randomized, open, multicenter and two branches of parallel intervention clinical trial.
Intervention Study: primary care pharmacist apply the GP-GP algorithm to each drug with the support of STOPP criteria, Beers and / or recommendations CatSalut. The pharmacist submit to doctor his findings and reach a consensus and decide which recommendations will be presented to patient. Control intervention: usual procedure.
Main outcome measures: a) Discontinued medications, changed or changing doses, b) GP consultations, hospital emergency department and hospital admissions for acute illness, c) pharmaceutical expenditure, d) restart medication e) complications underlying diseases. Follow-up control at 1 month (security) and at 3, 6 and 12 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pharmacist Intervention | Experimental | Primary care pharmacist apply the GP-GP algorithm to each drug with the support of STOPP criteria, Beers and / or recommendations CatSalut. The pharmacist submit to doctor his findings and reach a consensus and decide which recommendations will be presented to patient. |
|
| Control | No Intervention | Usual procedure. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pharmacist Intervention | Procedure |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with medications discontinued, reduced dose or changed. | baseline, 3, 6 and 12 months | |
| Number of discontinued medications, changed or changing doses. | baseline, 3, 6 and 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Resumption of medication | 3, 6 and 12 months | |
| Medication adherence | Morisky-Green questionnaire | baseline, 3 and 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27605543 | Derived | Campins L, Serra-Prat M, Gozalo I, Lopez D, Palomera E, Agusti C, Cabre M; REMEI Group. Randomized controlled trial of an intervention to improve drug appropriateness in community-dwelling polymedicated elderly people. Fam Pract. 2017 Feb;34(1):36-42. doi: 10.1093/fampra/cmw073. Epub 2016 Sep 7. |
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| Quality of life |
EuroQoL questionnaire |
| baseline, 3 and 6 months |
| Pharmaceutical recommendations acceptance rate | baseline |
| Healthcare resource consumption | Number of visits to Primary care center, Number of visits to hospital emergency department, Number of hospital admission, Number of outpatients hospital visits. | 3, 6 and 12 months |
| Mortality | 3, 6 and 12 months |