Health Economic Evaluation Alongside the OPERAM Trial
3 or More Chronic Conditions for 6 Months or Longer, 5 or More Regular Drugs
About this trial
This is an interventional treatment trial for 3 or More Chronic Conditions for 6 Months or Longer focused on measuring Drug Utilization Review, Older people, Health economics
Eligibility Criteria
Inclusion Criteria:
- People 70 years of age or older
- Multimorbidity: 3 or more coexistent chronic conditions defined by 3 distinct International Classification of Diseases (ICD-10) codes with an estimated duration of 6 months or more or based on a clinical decision
- Polypharmacy i.e. five or more different regular drugs (defined as authorised medications with registration numbers) for more than 30 days.
- Estimated minimal length of stay within the cluster is sufficient to apply the intervention
- If outpatient: prescribing physician has GP function and has a planned appointment to conduct intervention
Exclusion Criteria:
- Inability to provide informed consent or to obtain informed consent from a proxy for patients with cognitive impairment
- Direct admission to palliative care (< 24h after admission)
- Has passed or will pass a systematic structured drug review during this hospitalisation or within the last two months
Sites / Locations
- Cliniques universitaires Saint-Luc
- Dept. of Medicine (Geriatrics), University College Cork
- Universitair Medisch Centrum Utrecht
- University of Bern and University Hospital Bern (Inselspital)
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
STRIP intervention
Control
The intervention will take place during the initial hospital admission (Index Hospitalisation) or an equivalent situation for outpatients. STRIP is a structured method to perform pharmacotherapy optimisation. The STRIP-intervention consists of 9 steps.
Participants in the control group will receive medication review by the prescribing physicians in accordance with usual care. If an extended drug review is in place in a ward/specialty corresponding characteristics are collected on cluster level.