Person-centred care provided by a multidisciplinary primary care team to improve therapeutic adequacy in polymedicated elderly patients (PCMR): randomised controlled trial protocol.
geriatric medicine
health & safety
primary care
protocols & guidelines
rationing
therapeutics
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
09 Feb 2022
09 Feb 2022
Historique:
entrez:
10
2
2022
pubmed:
11
2
2022
medline:
23
3
2022
Statut:
epublish
Résumé
The increase in elderly population has led to an associated increase in multiple pathologies, frailty, polypharmacy, healthcare costs, decreased quality of life and mortality. We designed an intervention based on person-centred care model. This article outlines a study protocol, which aims to explore the effects of the intervention to improve therapeutic adequacy in polymedicated elderly patients. An open, randomised, multicentre, controlled clinical trial. The study population includes polymedicated (≥8 prescription medications) patients ≥75 years old. In the intervention group, the multidisciplinary team (primary care pharmacist, family doctor and nurse) will meet to carry out multidimensional reviews (frailty, clinical complexity, morbidity and therapeutic adequacy) of the study subjects. If changes are proposed to the treatment plan, a clinical interview will be conducted with the patient to agree on changes in accordance with their preferences. Follow-up visits will be scheduled at 6 and 12 months. In the control group, where the usual clinical practice will be followed, the necessary data will be collected to compare the results.The key variables are the variation in the mean number of incidents (potentially inappropriate prescription) per patient, the number of medications, the number of changes implemented to the treatment plan and the variation in the number of hospital admissions. This study was approved by the Ethics Committee of the IDIAPJGol and by the University of Barcelona's Bioethics Commission. The results are expected to be published in peer reviewed open-access journals, and as part of a doctoral thesis. NCT04188470. Pre-results.
Identifiants
pubmed: 35140146
pii: bmjopen-2021-051238
doi: 10.1136/bmjopen-2021-051238
pmc: PMC8830237
doi:
Banques de données
ClinicalTrials.gov
['NCT04188470']
Types de publication
Clinical Trial Protocol
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e051238Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Md State Med J. 1965 Feb;14:61-5
pubmed: 14258950
Lancet. 2007 Jul 14;370(9582):173-184
pubmed: 17630041
Fam Pract. 2017 Feb;34(1):36-42
pubmed: 27605543
Aten Primaria. 2016 Dec;48(10):674-682
pubmed: 27495004
Arch Intern Med. 2006 Mar 27;166(6):605-9
pubmed: 16567597
J Am Med Dir Assoc. 2018 Jan;19(1):46-52
pubmed: 28899661
Clin Interv Aging. 2009;4:225-33
pubmed: 19554093
Eur J Hosp Pharm. 2017 Jan;24(1):5-6
pubmed: 31156889
Patient Prefer Adherence. 2018 May 07;12:721-731
pubmed: 29765208
Rev Esp Geriatr Gerontol. 2015 Mar-Apr;50(2):89-96
pubmed: 25466971
Arch Gerontol Geriatr. 2018 Sep - Oct;78:213-220
pubmed: 30015057
J Am Geriatr Soc. 1975 Oct;23(10):433-41
pubmed: 1159263
J Am Med Dir Assoc. 2019 Mar;20(3):362-372.e11
pubmed: 30581126
J Am Geriatr Soc. 2015 Nov;63(11):2227-46
pubmed: 26446832
Rev Saude Publica. 2018 Jul 26;52:74
pubmed: 30066813
BMC Fam Pract. 2020 Jun 8;21(1):100
pubmed: 32513110
Hosp Community Psychiatry. 1985 Jun;36(6):593-5
pubmed: 4007814
J Am Med Dir Assoc. 2017 Jan;18(1):8-9
pubmed: 27887892
J Gerontol A Biol Sci Med Sci. 2013 Jan;68(1):62-7
pubmed: 22511289
Med Clin (Barc). 2019 Aug 16;153(4):141-150
pubmed: 30803798
Geriatr Gerontol Int. 2017 Nov;17(11):2200-2207
pubmed: 28544188
Age Ageing. 2015 Jan;44(1):46-53
pubmed: 25103030
Nurs Res. 1987 Jul-Aug;36(4):205-10
pubmed: 3299278
Arch Intern Med. 2010 Jul 12;170(13):1142-8
pubmed: 20625022
J Clin Epidemiol. 1992 Oct;45(10):1045-51
pubmed: 1474400
Age Ageing. 2017 Jul 1;46(4):600-607
pubmed: 28119312
Age Ageing. 2016 Jan;45(1):115-20
pubmed: 26683048
Rev Esp Geriatr Gerontol. 2017 Sep - Oct;52(5):278-281
pubmed: 28476211
Aten Primaria. 2017 Oct;49(8):459-464
pubmed: 28390732
Med Clin (Barc). 2013 Mar 16;140(6):241-5
pubmed: 23103110
BMC Fam Pract. 2018 Jul 18;19(1):113
pubmed: 30021528
Ann Intern Med. 2013 Feb 5;158(3):200-7
pubmed: 23295957
Res Social Adm Pharm. 2014 Jul-Aug;10(4):608-22
pubmed: 24161491
Rev Esp Geriatr Gerontol. 2017 May - Jun;52(3):119-127
pubmed: 28029467