Evidence map›Paper›PMID 31481568›Full record

ArticleBMJ open2019

'Optimising PharmacoTherapy In the multimorbid elderly in primary CAre' (OPTICA) to improve medication appropriateness: study protocol of a cluster randomised controlled trial.

Katharina Tabea Jungo, Zsofia Rozsnyai, Sophie Mantelli, Carmen Floriani, Axel Lennart Löwe, Fanny Lindemann, Nathalie Schwab, Rahel Meier, Lamia Elloumi, Corlina Johanna Alida Huibers and 12 more

Registry-linked trialAbstract 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 NCT03724539 (Optimizing PharmacoTherapy In the Multimorbid Elderly in Primary CAre), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT03724539 nacompletednot on this map

Optimizing PharmacoTherapy In the Multimorbid Elderly in Primary CAre: a Cluster Randomized Controlled Trial (the OPTICA Trial)

TypeinterventionalSponsorUniversity of BernRan2019 to 2021Enrolled323ConditionsMultimorbidity, PolypharmacyArmsSTRIPA intervention, Sham intervention
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Attitudes toward deprescribing in a middle-aged health disparities population.Research in social & administrative pharmacy : RSAP · 2020
    Article
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

22 authors.

Katharina Tabea JungoInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.ORCID 0000-0002-1782-1345
Zsofia RozsnyaiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Sophie MantelliInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Carmen FlorianiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Axel Lennart LöweInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Fanny LindemannInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Nathalie SchwabInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Rahel MeierInstitute of Primary Care, University of Zurich, Zurich, Switzerland.ORCID 0000-0001-8159-9753
Lamia ElloumiDepartment of Information and Computing Sciences, Utrecht University, Utrecht, The Netherlands.
Corlina Johanna Alida HuibersDepartment of Geriatric Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
Bastiaan Theodoor Gerard Marie SalleveltDepartment of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, The Netherlands.
Michiel C MeulendijkDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Emily ReeveQuality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
Martin FellerInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Claudio SchneiderDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Heinz BhendHausarzt Praxis Städtli Aarburg, Aarburg, Switzerland.
Pius M BürkiBerufsverband der Haus- und Kinderärztinnen Schweiz, Bern, Switzerland.
S TrelleCTU Bern, University of Bern, Bern, Switzerland.
Marco SpruitDepartment of Information and Computing Sciences, Utrecht University, Utrecht, The Netherlands.
Matthias SchwenkglenksInstitute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland.
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Sven StreitInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland sven.streit@biham.unibe.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMultimorbidity and polypharmacy are major risk factors for potentially inappropriate prescribing (eg, overprescribing and underprescribing), and systematic medication reviews are complex and time consuming. In this trial, the investigators aim to determine if a systematic software-based medication review improves medication appropriateness more than standard care in older, multimorbid patients with polypharmacy. METHODS AND ANALYSIS: Optimising PharmacoTherapy In the multimorbid elderly in primary CAre is a cluster randomised controlled trial that will include outpatients from the Swiss primary care setting, aged ≥65 years with ≥three chronic medical conditions and concurrent use of ≥five chronic medications. Patients treated by the same general practitioner (GP) constitute a cluster, and clusters are randomised 1:1 to either a standard care sham intervention, in which the GP discusses with the patient if the medication list is complete, or a systematic medication review intervention based on the use of the 'Systematic Tool to Reduce Inappropriate Prescribing'-Assistant (STRIPA). STRIPA is a web-based clinical decision support system that helps customise medication reviews. It is based on the validated 'Screening Tool of Older Person's Prescriptions' (STOPP) and 'Screening Tool to Alert doctors to Right Treatment' (START) criteria to detect potentially inappropriate prescribing. The trial's follow-up period is 12 months. Outcomes will be assessed at baseline, 6 and 12 months. The primary endpoint is medication appropriateness, as measured jointly by the change in the Medication Appropriateness Index (MAI) and Assessment of Underutilisation (AOU). Secondary endpoints include the degree of polypharmacy, overprescribing and underprescribing, the number of falls and fractures, quality of life, the amount of formal and informal care received by patients, survival, patients' quality adjusted life years, patients' medical costs, cost-effectiveness of the intervention, percentage of recommendations accepted by GPs, percentage of recommendation rejected by GPs and patients' willingness to have medications deprescribed. ETHICS AND DISSEMINATION: The ethics committee of the canton of Bern in Switzerland approved the trial protocol. The results of this trial will be published in a peer-reviewed journal. MAIN

fundingSwiss National Science Foundation, National Research Programme (NRP 74) 'Smarter Healthcare'. TRIAL REGISTRATION NUMBERS: Clinicaltrials.gov (NCT03724539), KOFAM (Swiss national portal) (SNCTP000003060), Universal Trial Number (U1111-1226-8013).

Indexed as

Decision Support Systems, ClinicalQuality of LifeAgedAged, 80 and overFemaleGeneral PractitionersHumansInappropriate PrescribingMaleMultimorbidityPotentially Inappropriate Medication ListPrimary Health CareRandomized Controlled Trials as TopicSwitzerlandmultimorbiditypolypharmacyprimary care

Identifiers

PMID31481568
PMCPMC6731954

What OpenQuestion holds

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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.