Cooperation between geriatricians and general practitioners for improved pharmacotherapy in home-dwelling elderly people receiving polypharmacy - the COOP Study : study protocol for a cluster randomised controlled trial

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Romskaug , R , Molden , E , Straand , J , Kersten , H , Skovlund , E , Pitkala , K H & Wyller , T B 2017 , ' Cooperation between geriatricians and general practitioners for improved pharmacotherapy in home-dwelling elderly people receiving polypharmacy - the COOP Study : study protocol for a cluster randomised controlled trial ' , Trials , vol. 18 , 158 . https://doi.org/10.1186/s13063-017-1900-0

Title: Cooperation between geriatricians and general practitioners for improved pharmacotherapy in home-dwelling elderly people receiving polypharmacy - the COOP Study : study protocol for a cluster randomised controlled trial
Author: Romskaug, Rita; Molden, Espen; Straand, Jorund; Kersten, Hege; Skovlund, Eva; Pitkala, Kaisu H.; Wyller, Torgeir Bruun
Contributor: University of Helsinki, Clinicum
Date: 2017-04-04
Language: eng
Number of pages: 9
Belongs to series: Trials
ISSN: 1745-6215
URI: http://hdl.handle.net/10138/182575
Abstract: Background: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various interventions for improving drug treatment have been evaluated, but the majority of studies are limited by the use of surrogate outcomes or suboptimal design. Thus, the potential for clinically significant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate the effect upon patient-relevant endpoints of a cooperation between geriatricians and general practitioners on complex drug regimens in home-dwelling elderly people. Methods: This is a cluster randomised, single-blind, controlled trial where general practitioners are invited to participate with patients from their lists. The patients must be 70 years or older, use at least seven different medications and have their medications administered by the home nursing service. We plan to recruit 200 patients, with randomisation at physician level. The intervention consists of three main parts: ( 1) clinical geriatric assessment of the patient, combined with a thorough review of their medications; ( 2) a meeting between the geriatrician and general practitioner, where the two physicians combine their competence and knowledge and discuss the drug list systematically; ( 3) clinical follow-up, depending on the medication changes that have been done. The study period is 24 weeks, and the patients are assessed at baseline, 16 and 24 weeks. The primary outcome measure is health-related quality of life according to the 15D instrument. Secondary outcome measures include physical and cognitive functioning, medication appropriateness, falls, carer burden, use of health services ( hospital or nursing home admissions, use of home nursing services) and mortality. Discussion: Our choice of patient-relevant outcome measures will hopefully provide new knowledge on the potential for clinical improvements after performing comprehensive medication reviews in home-dwelling elderly people receiving polypharmacy.
Subject: Polypharmacy
Inappropriate drug use
Medication review
Geriatrics
Elderly
Home-dwelling
ADVERSE DRUG-REACTIONS
QUALITY-OF-LIFE
POTENTIALLY INAPPROPRIATE
OLDER PATIENTS
MEDICATION USE
STOPP/START CRITERIA
MULTIPLE CONDITIONS
MANAGEMENT UNIT
GAIT SPEED
SHORT-FORM
3142 Public health care science, environmental and occupational health
3121 General medicine, internal medicine and other clinical medicine
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