Trial reportImplementation science : IS2017
Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy: study protocol of a cluster randomized clinical trial (Multi-PAP project).
Trial report in Implementation science : IS, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02866799 (Effectiveness of an Intervention for Improving Drug Prescription in Primary Care Patients With Multimorbidity and Polypharmacy), which is not on this map. Cited by 28 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of an Intervention for Improving Drug Prescription in Primary Care Patients With Multimorbidity and Polypharmacy: Study Protocol of a Cluster Randomized Clinical Trial (Multi-PAP Project)
Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Interventions to improve the appropriate use of polypharmacy for older people.The Cochrane database of systematic reviews · 2023Pooled it
- Interventions for improving medication-taking ability and adherence in older adults prescribed multiple medications.The Cochrane database of systematic reviews · 2020Pooled it
- Interventions to improve the appropriate use of polypharmacy for older people.The Cochrane database of systematic reviews · 2018Pooled it
- Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE): a cluster randomised controlled trial protocol and pilot.Implementation science : IS · 2017Trial
- Polypharmacy in Older Adults: A Narrative Review of Clinical Risks, Deprescribing Strategies, and Interdisciplinary Management.Geriatrics (Basel, Switzerland) · 2026Review
- Influence of social determinants of health on quality of life in patients with multimorbidity and polypharmacy.PloS one · 2024Observational
- How to Improve Healthcare for Patients with Multimorbidity and Polypharmacy in Primary Care: A Pragmatic Cluster-Randomized Clinical Trial of the MULTIPAP Intervention.Journal of personalized medicine · 2022Article
- Sex differences in social support perceived by polymedicated older adults with multimorbidity. MULTIPAP study.PloS one · 2022Article
- Assessment of Potentially Inappropriate Medications Using the EU (7)-PIM List, in a Sample of Portuguese Older Adults' Residents in Nursing Homes.Risk management and healthcare policy · 2022Article
- Drug interactions detected by a computer-assisted prescription system in primary care patients in Spain: MULTIPAP study.The European journal of general practice · 2021Observational
- Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years' Follow-Up.Journal of clinical medicine · 2021Article
- Assessing the Pilot Implementation of the Integrated Multimorbidity Care Model in Five European Settings: Results from the Joint Action CHRODIS-PLUS.International journal of environmental research and public health · 2020Article
- Integrated care for the management of ageing-related non-communicable diseases: current gaps and future directions.Aging clinical and experimental research · 2020Article
- Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study.International journal of environmental research and public health · 2020Article
- Use of an Electronic Clinical Decision Support System in Primary Care to Assess Inappropriate Polypharmacy in Young Seniors With Multimorbidity: Observational, Descriptive, Cross-sectional Study.JMIR medical informatics · 2020Article
- The analysis of the use of potentially inappropriate medications in elderly in the Slovak Republic.International journal of clinical pharmacy · 2020Article
- Observational
- Observational
- Application of the JA-CHRODIS Integrated Multimorbidity Care Model (IMCM) to a Case Study of Diabetes and Mental Health.International journal of environmental research and public health · 2019Article
- A Methodological Approach for Implementing an Integrated Multimorbidity Care Model: Results from the Pre-Implementation Stage of Joint Action CHRODIS-PLUS.International journal of environmental research and public health · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
25 authors at 7 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12 months, as compared with usual care. METHODS/
designDesign: pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. SCOPE: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). POPULATION: patients aged 65-74 years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3 months). SAMPLE SIZE: n = 400 (200 per study arm).
interventioncomplex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. OUTCOMES: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. STATISTICAL ANALYSIS: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. DISCUSSION: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes.
trial registrationClinicaltrials.gov, NCT02866799.
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