Person-centred care provided by a multidisciplinary primary care team to improve therapeutic adequacy in polymedicated elderly patients (PCMR): randomised controlled trial protocol

Carol Rovira, Pilar Modamio, Joaquim Pascual, Joan Armengol, Cristian Ayala, Joan Gallego, Eduardo L Mariño, Anna Ramirez, PCMR (Person-Centred Medication Review) Study Group, Carol Rovira, Pilar Modamio, Joaquim Pascual, Joan Armengol, Cristian Ayala, Joan Gallego, Eduardo L Mariño, Anna Ramirez, PCMR (Person-Centred Medication Review) Study Group

Abstract

Introduction: 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.

Methods and analysis: 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.

Ethics and dissemination: 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.

Trial registration number: NCT04188470. Pre-results.

Keywords: geriatric medicine; health & safety; primary care; protocols & guidelines; rationing; therapeutics.

Conflict of interest statement

Competing interests: None declared.

© 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.

Figures

Figure 1
Figure 1
Study flow diagram. PCT, primary care team.
Figure 2
Figure 2
Person-centred care model of the PCMR study (Intervention). PCP, primary care pharmacist; PCMR, Person-Centred Medication Review; SEFAP, Spanish Society of Primary Care Pharmacists.

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Source: PubMed

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