Evidence map›Paper›PMID 31164366›Full record

ArticleBMJ open2019

Rationale and design of OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM): a cluster randomised controlled trial.

Luise Adam, Elisavet Moutzouri, Christine Baumgartner, Axel Lennart Loewe, Martin Feller, Khadija M'Rabet-Bensalah, Nathalie Schwab, Stefanie Hossmann, Claudio Schneider, Sabrina Jegerlehner and 21 more

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02986425 (OPERAM), which is not on this map. Cited by 46 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 2 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02986425 nacompletednot on this map

OPERAM: OPtimising thERapy to Prevent Avoidable Hospital Admissions in the Multimorbid Older People: a Cluster Randomised Controlled Trial

TypeinterventionalSponsorInsel Gruppe AG, University Hospital BernRan2016 to 2019Enrolled2,009Conditions3 or More Chronic Conditions for 6 Months or Longer, 5 or More Regular DrugsArmsSTRIP intervention, Control
3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 2 syntheses or guidelines pooled it, 65 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 5 institutions in 6 countries.

Luise AdamDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Elisavet MoutzouriDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Christine BaumgartnerDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Axel Lennart LoeweDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Martin FellerDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Khadija M'Rabet-BensalahDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Nathalie SchwabDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Stefanie HossmannClinical Trial Unit Bern, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Claudio SchneiderDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Sabrina JegerlehnerDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Carmen FlorianiDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Andreas LimacherClinical Trial Unit Bern, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Katharina Tabea JungoInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.ORCID 0000-0002-1782-1345
Corlina Johanna Alida HuibersDepartment of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Sven StreitInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Matthias SchwenkglenksInstitute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland.
Marco SpruitDepartment of Information and Computing Sciences, Utrecht University, Utrecht, The Netherlands.
Anette Van DorlandDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Jacques DonzéDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Patricia M KearneyDepartment of Epidemiology and Public Health, University College Cork, Cork, Ireland.
Peter JüniClinical Trial Unit Bern, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Drahomir AujeskyDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Paul JansenDepartment of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Benoit BolandCliniques universitaires Saint-Luc, Université catholique de Louvain, Louvain, Belgium.
Olivia DalleurCliniques universitaires Saint-Luc, Université catholique de Louvain, Louvain, Belgium.
Stephen ByrneSchool of Pharmacy, University College Cork, Cork, Ireland.
Wilma KnolDepartment of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Anne SpinewineLouvain Drug Research Institute - Clinical Pharmacy, Université catholique de Louvain, Louvain, Belgium.
Denis O'MahonyDepartment of Medicine (Geriatrics), University College Cork and Cork University Hospital, Cork, Ireland.
Sven TrelleClinical Trial Unit Bern, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Nicolas RodondiDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
University of Bern · CHUtrecht University · NLCliniques Universitaires Saint-Luc · BEUniversity College Cork · IEUniversity of Basel · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMultimorbidity and polypharmacy are important risk factors for drug-related hospital admissions (DRAs). DRAs are often linked to prescribing problems (overprescribing and underprescribing), as well as non-adherence with drug regimens for different reasons. In this trial, we aim to assess whether a structured medication review compared with standard care can reduce DRAs in multimorbid older patients with polypharmacy. METHODS AND ANALYSIS: OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people is a European multicentre, cluster randomised, controlled trial. Hospitalised patients ≥70 years with ≥3 chronic medical conditions and concurrent use of ≥5 chronic medications are included in the four participating study centres of Bern (Switzerland), Utrecht (The Netherlands), Brussels (Belgium) and Cork (Ireland). Patients treated by the same prescribing physician constitute a cluster, and clusters are randomised 1:1 to either standard care or Systematic Tool to Reduce Inappropriate Prescribing (STRIP) intervention with the help of a clinical decision support system, the STRIP Assistant. STRIP is a structured method performing customised medication reviews, based on Screening Tool of Older People's Prescriptions/Screening  Tool to Alert to Right Treatment criteria to detect potentially inappropriate prescribing. The primary endpoint is any DRA where the main reason or a contributory reason for the patient's admission is caused by overtreatment or undertreatment, and/or inappropriate treatment. Secondary endpoints include number of any hospitalisations, all-cause mortality, number of falls, quality of life, degree of polypharmacy, activities of daily living, patient's drug compliance, the number of significant drug-drug interactions, drug overuse and underuse and potentially inappropriate medication. ETHICS AND DISSEMINATION: The local Ethics Committees in Switzerland, Ireland, The Netherlands and Belgium approved this trial protocol. We will publish the results of this trial in a peer-reviewed journal. MAIN

fundingEuropean Union's Horizon 2020 programme. TRIAL REGISTRATION NUMBER: NCT02986425 , SNCTP000002183 , NTR6012, U1111-1181-9400.

Indexed as

GeriatricsAgedAged, 80 and overChronic DiseaseCluster AnalysisDecision Support Systems, ClinicalDrug-Related Side Effects and Adverse ReactionsFemaleHospitalizationHumansInappropriate PrescribingMaleMultimorbidityPolypharmacyPotentially Inappropriate Medication ListQuality of Lifeclinical pharmacologygeneral medicine (see internal medicine)geriatric medicineinternal medicine

Identifiers

PMID31164366
PMCPMC6561415
OpenAlexW2948899220

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.