Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.

Del Cura-González, Isabel; López-Rodríguez, Juan A; Leiva-Fernández, Francisca; Gimeno-Feliú, Luis A; Pico-Soler, Victoria; Bujalance-Zafra, Mª Josefa; Domínguez-Santaella, Miguel; Polentinos-Castro, Elena; Poblador-Plou, Beatriz; Ara-Bardají, Paula; Aza-Pascual-Salcedo, Mercedes; Rogero-Blanco, Marisa; Castillo-Jiménez, Marcos; Lozano-Hernández, Cristina; Gimeno-Miguel, Antonio; González-Rubio, Francisca; Medina-García, Rodrigo; González-Hevilla, Alba; Gil-Conesa, Mario; Valderas, José M; Marengoni, Alessandra; Muth, Christiane; Prados-Torres, J Daniel; Prados-Torres, Alexandra; MULTIPAP PLUS Group

Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.

The progressive ageing of the population is leading to an increase in multimorbidity and polypharmacy, which in turn may increase the risk of hospitalization and mortality. The enhancement of care with information and communications technology (ICT) can facilitate the use of prescription evaluation...

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Autores:	Del Cura-González, Isabel, López-Rodríguez, Juan A, Leiva-Fernández, Francisca, Gimeno-Feliú, Luis A, Pico-Soler, Victoria, Bujalance-Zafra, Mª Josefa, Domínguez-Santaella, Miguel, Polentinos-Castro, Elena, Poblador-Plou, Beatriz, Ara-Bardají, Paula, Aza-Pascual-Salcedo, Mercedes, Rogero-Blanco, Marisa, Castillo-Jiménez, Marcos, Lozano-Hernández, Cristina, Gimeno-Miguel, Antonio, González-Rubio, Francisca, Medina-García, Rodrigo, González-Hevilla, Alba, Gil-Conesa, Mario, Valderas, José M, Marengoni, Alessandra, Muth, Christiane, Prados-Torres, J Daniel, Prados-Torres, Alexandra, MULTIPAP PLUS Group
Formato:	artículo
Fecha de publicación:	2022
País:	España
Recursos:	Instituto de Salud Carlos III (ISCIII)
Repositorio:	Repisalud
Idioma:	inglés
OAI Identifier:	oai:repisalud.isciii.es:20.500.12105/18672
Acesso em linha:	http://hdl.handle.net/20.500.12105/18672
Access Level:	acceso abierto
Palavra-chave:	Cluster randomized controlled trial Computer-assisted Decision-making Medication reconciliation Multimorbidity Patient-centred care Polypharmacy Primary health care Aged Chronic Disease Humans Primary Health Care Quality of Life Randomized Controlled Trials as Topic

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network_name_str	España
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spelling	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.Del Cura-González, IsabelLópez-Rodríguez, Juan ALeiva-Fernández, FranciscaGimeno-Feliú, Luis APico-Soler, VictoriaBujalance-Zafra, Mª JosefaDomínguez-Santaella, MiguelPolentinos-Castro, ElenaPoblador-Plou, BeatrizAra-Bardají, PaulaAza-Pascual-Salcedo, MercedesRogero-Blanco, MarisaCastillo-Jiménez, MarcosLozano-Hernández, CristinaGimeno-Miguel, AntonioGonzález-Rubio, FranciscaMedina-García, RodrigoGonzález-Hevilla, AlbaGil-Conesa, MarioValderas, José MMarengoni, AlessandraMuth, ChristianePrados-Torres, J DanielPrados-Torres, AlexandraMULTIPAP PLUS GroupCluster randomized controlled trialComputer-assistedDecision-makingMedication reconciliationMultimorbidityPatient-centred carePolypharmacyPrimary health careAgedChronic DiseaseHumansMultimorbidityPolypharmacyPrimary Health CareQuality of LifeRandomized Controlled Trials as TopicThe progressive ageing of the population is leading to an increase in multimorbidity and polypharmacy, which in turn may increase the risk of hospitalization and mortality. The enhancement of care with information and communications technology (ICT) can facilitate the use of prescription evaluation tools and support system for decision-making (DSS) with the potential of optimizing the healthcare delivery process. To assess the effectiveness and cost-effectiveness of the complex intervention MULTIPAP Plus, compared to usual care, in improving prescriptions for young-old patients (65-74 years old) with multimorbidity and polypharmacy in primary care. This is a pragmatic cluster-randomized clinical trial with a follow-up of 18 months in health centres of the Spanish National Health System. Unit of randomization: family physician. Unit of analysis: patient. Patients aged 65-74 years with multimorbidity (≥ 3 chronic diseases) and polypharmacy (≥ 5 drugs) during the previous 3 months were included. n = 1148 patients (574 per study arm). Complex intervention based on the ARIADNE principles with three components: (1) family physician (FP) training, (2) FP-patient interview, and (3) decision-making support system. The primary outcome is a composite endpoint of hospital admission or death during the observation period measured as a binary outcome, and the secondary outcomes are number of hospital admission, all-cause mortality, use of health services, quality of life (EQ-5D-5L), functionality (WHODAS), falls, hip fractures, prescriptions and adherence to treatment. Clinical and sociodemographic factors will be explanatory variables. The main result is the difference in percentages in the final composite endpoint variable at 18 months, with its corresponding 95% CI. Adjustments by the main confounding and prognostic factors will be performed through a multilevel analysis. All analyses will be carried out in accordance to the intention-to-treat principle. It is important to prevent the cascade of negative health and health care impacts attributable to the multimorbidity-polypharmacy binomial. ICT-enhanced routine clinical practice could improve the prescription process in patient care. ClinicalTrials.gov NCT04147130 . Registered on 22 October 2019.20242024-02-2720222022-06-0920222022-06-09research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articlehttp://hdl.handle.net/20.500.12105/18672reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/186722026-06-12T12:43:37Z
dc.title.none.fl_str_mv	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.
title	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.
spellingShingle	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial. Del Cura-González, Isabel Cluster randomized controlled trial Computer-assisted Decision-making Medication reconciliation Multimorbidity Patient-centred care Polypharmacy Primary health care Aged Chronic Disease Humans Multimorbidity Polypharmacy Primary Health Care Quality of Life Randomized Controlled Trials as Topic
title_short	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.
title_full	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.
title_fullStr	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.
title_full_unstemmed	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.
title_sort	Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.
dc.creator.none.fl_str_mv	Del Cura-González, Isabel López-Rodríguez, Juan A Leiva-Fernández, Francisca Gimeno-Feliú, Luis A Pico-Soler, Victoria Bujalance-Zafra, Mª Josefa Domínguez-Santaella, Miguel Polentinos-Castro, Elena Poblador-Plou, Beatriz Ara-Bardají, Paula Aza-Pascual-Salcedo, Mercedes Rogero-Blanco, Marisa Castillo-Jiménez, Marcos Lozano-Hernández, Cristina Gimeno-Miguel, Antonio González-Rubio, Francisca Medina-García, Rodrigo González-Hevilla, Alba Gil-Conesa, Mario Valderas, José M Marengoni, Alessandra Muth, Christiane Prados-Torres, J Daniel Prados-Torres, Alexandra MULTIPAP PLUS Group
author	Del Cura-González, Isabel
author_facet	Del Cura-González, Isabel López-Rodríguez, Juan A Leiva-Fernández, Francisca Gimeno-Feliú, Luis A Pico-Soler, Victoria Bujalance-Zafra, Mª Josefa Domínguez-Santaella, Miguel Polentinos-Castro, Elena Poblador-Plou, Beatriz Ara-Bardají, Paula Aza-Pascual-Salcedo, Mercedes Rogero-Blanco, Marisa Castillo-Jiménez, Marcos Lozano-Hernández, Cristina Gimeno-Miguel, Antonio González-Rubio, Francisca Medina-García, Rodrigo González-Hevilla, Alba Gil-Conesa, Mario Valderas, José M Marengoni, Alessandra Muth, Christiane Prados-Torres, J Daniel Prados-Torres, Alexandra MULTIPAP PLUS Group
author_role	author
author2	López-Rodríguez, Juan A Leiva-Fernández, Francisca Gimeno-Feliú, Luis A Pico-Soler, Victoria Bujalance-Zafra, Mª Josefa Domínguez-Santaella, Miguel Polentinos-Castro, Elena Poblador-Plou, Beatriz Ara-Bardají, Paula Aza-Pascual-Salcedo, Mercedes Rogero-Blanco, Marisa Castillo-Jiménez, Marcos Lozano-Hernández, Cristina Gimeno-Miguel, Antonio González-Rubio, Francisca Medina-García, Rodrigo González-Hevilla, Alba Gil-Conesa, Mario Valderas, José M Marengoni, Alessandra Muth, Christiane Prados-Torres, J Daniel Prados-Torres, Alexandra MULTIPAP PLUS Group
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv	Cluster randomized controlled trial Computer-assisted Decision-making Medication reconciliation Multimorbidity Patient-centred care Polypharmacy Primary health care Aged Chronic Disease Humans Multimorbidity Polypharmacy Primary Health Care Quality of Life Randomized Controlled Trials as Topic
topic	Cluster randomized controlled trial Computer-assisted Decision-making Medication reconciliation Multimorbidity Patient-centred care Polypharmacy Primary health care Aged Chronic Disease Humans Multimorbidity Polypharmacy Primary Health Care Quality of Life Randomized Controlled Trials as Topic
description	The progressive ageing of the population is leading to an increase in multimorbidity and polypharmacy, which in turn may increase the risk of hospitalization and mortality. The enhancement of care with information and communications technology (ICT) can facilitate the use of prescription evaluation tools and support system for decision-making (DSS) with the potential of optimizing the healthcare delivery process. To assess the effectiveness and cost-effectiveness of the complex intervention MULTIPAP Plus, compared to usual care, in improving prescriptions for young-old patients (65-74 years old) with multimorbidity and polypharmacy in primary care. This is a pragmatic cluster-randomized clinical trial with a follow-up of 18 months in health centres of the Spanish National Health System. Unit of randomization: family physician. Unit of analysis: patient. Patients aged 65-74 years with multimorbidity (≥ 3 chronic diseases) and polypharmacy (≥ 5 drugs) during the previous 3 months were included. n = 1148 patients (574 per study arm). Complex intervention based on the ARIADNE principles with three components: (1) family physician (FP) training, (2) FP-patient interview, and (3) decision-making support system. The primary outcome is a composite endpoint of hospital admission or death during the observation period measured as a binary outcome, and the secondary outcomes are number of hospital admission, all-cause mortality, use of health services, quality of life (EQ-5D-5L), functionality (WHODAS), falls, hip fractures, prescriptions and adherence to treatment. Clinical and sociodemographic factors will be explanatory variables. The main result is the difference in percentages in the final composite endpoint variable at 18 months, with its corresponding 95% CI. Adjustments by the main confounding and prognostic factors will be performed through a multilevel analysis. All analyses will be carried out in accordance to the intention-to-treat principle. It is important to prevent the cascade of negative health and health care impacts attributable to the multimorbidity-polypharmacy binomial. ICT-enhanced routine clinical practice could improve the prescription process in patient care. ClinicalTrials.gov NCT04147130 . Registered on 22 October 2019.
publishDate	2022
dc.date.none.fl_str_mv	2022 2022-06-09 2022 2022-06-09 2024 2024-02-27
dc.type.none.fl_str_mv	research article http://purl.org/coar/resource_type/c_2df8fbb1 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv	info:eu-repo/semantics/article
format	article
dc.identifier.none.fl_str_mv	http://hdl.handle.net/20.500.12105/18672
url	http://hdl.handle.net/20.500.12105/18672
dc.language.none.fl_str_mv	Inglés eng
language_invalid_str_mv	Inglés
language	eng
dc.rights.none.fl_str_mv	open access http://purl.org/coar/access_right/c_abf2 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv	info:eu-repo/semantics/openAccess
rights_invalid_str_mv	open access http://purl.org/coar/access_right/c_abf2 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv	openAccess
dc.source.none.fl_str_mv	reponame:Repisalud instname:Instituto de Salud Carlos III (ISCIII)
instname_str	Instituto de Salud Carlos III (ISCIII)
reponame_str	Repisalud
collection	Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.

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