OPtimising thERapy to Prevent Avoidable Hospital Admissions in the Multimorbid Older People

Summary

The objective of this Randomised Controlled Trial (RCT) is to evaluate whether the Systematic Tool to Reduce Inappropriate Prescribing (STRIP) including STRIP assistant (STRIPA) implemented by an appropriately qualified team will lead to an improvement in clinical and economic outcomes among patients aged 70 years and more with multimorbidity and polypharmacy.

Conditions

• 3 or More Chronic Conditions for 6 Months or Longer
• 5 or More Regular Drugs

Interventions

OTHER

STRIP intervention

The STRIP intervention consists of 9 steps: 1. structured history taking of medication 2. recording medication and diagnoses in STRIPA 3. structured drug review based on the STRIPA with the integrated Screening Tool of Older Person's Prescriptions (STOPP)/ Screening Tool to Alert Doctors to the Right Treatment (START) criteria 4. communication and discussion of the structured drug review with prescribing physician with possible adaptation of the recommendation 5. shared decision-making with the patient with possible adaptation of the recommendation 6. optional revision based on new accumulating data during hospitalisation (e.g. new diagnoses, adverse drug reactions) 7. generation of general practioner (GP) report 8. delivery of the report to the patient and to the GP (optional additional direct communication) 9. follow-up

OTHER

Control

Standard care in the department where the trial is conducted. To keep the patients and the blinded team members blinded one questionnaire will be conducted by the intervention team in both arms. This is considered a SHAM intervention.

Sponsors & Collaborators

• Cliniques universitaires Saint-Luc- Université Catholique de Louvain

  collaborator OTHER

• Cork University Hospital

  collaborator OTHER

• UMC Utrecht

  collaborator OTHER

• University of Basel

  collaborator OTHER

• Université Catholique de Louvain

  collaborator OTHER

• Utrecht University

  collaborator OTHER

• University of Bern

  collaborator OTHER

• European Commission

  collaborator OTHER

• State Secretariat for Education Research and Innovation, Switzerland

  collaborator OTHER

• Insel Gruppe AG, University Hospital Bern

  lead OTHER

Principal Investigators

• Nicolas Rodondi, Prof. · Head of Ambulatory Care Department of General Internal Medicine Inselspital, Bern University Hospital, University of Bern, Switzerland; and Institute of Primary Health Care (BIHAM), University of Bern

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2016-12-31

Primary Completion

2019-10-31

Completion

2019-10-31

Countries

• Belgium
• Ireland
• Netherlands
• Switzerland

Study Locations