Evidence map›Paper›PMID 33741071›Full record

ArticlePilot and feasibility studies2021

An external pilot cluster randomised controlled trial of a theory-based intervention to improve appropriate polypharmacy in older people in primary care (PolyPrime): study protocol.

Audrey Rankin, Cathal A Cadogan, Heather E Barry, Evie Gardner, Ashley Agus, Gerard J Molloy, Ashleigh Gorman, Cristín Ryan, Claire Leathem, Marina Maxwell and 6 more

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Pilot and feasibility studies, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04181879 (A Pilot Cluster Randomised Controlled Trial of a Theory-based Intervention to Improve Appropriate Polypharmacy in Older People in Primary Care), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 17% 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.

NCT04181879 naunknown statusnot on this map

A Pilot Cluster Randomised Controlled Trial of a Theory-based Intervention to Improve Appropriate Polypharmacy in Older People in Primary Care

TypeinterventionalSponsorQueen's University, BelfastRan2019 to 2021Enrolled68ConditionsPolypharmacyArmsIntervention
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Selection and reporting of usual care comparators when designing primary care trials of complex health interventions: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Pooled it
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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

16 authors at 5 institutions in 2 countries.

Audrey RankinSchool of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
Cathal A CadoganSchool of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
Heather E BarrySchool of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
Evie GardnerNorthern Ireland Clinical Trials Unit, Belfast, UK.
Ashley AgusNorthern Ireland Clinical Trials Unit, Belfast, UK.
Gerard J MolloySchool of Psychology, National University of Ireland, Galway, Ireland.
Ashleigh GormanSchool of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
Cristín RyanSchool of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
Claire LeathemNorthern Ireland Clinical Research Network (Primary Care), Belfast, UK.
Marina MaxwellNorthern Ireland Clinical Research Network (Primary Care), Belfast, UK.
Gerard J GormleySchool of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Alan FerrettPublic Involvement Enhancing Research, Belfast, Northern Ireland, UK.
Pat McCarthyDonegal Volunteer Centre, Donegal, Ireland.
Tom FaheyDepartment of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.
Carmel M HughesSchool of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK. c.hughes@qub.ac.uk.ORCID http://orcid.org/0000-0002-4656-6021
PolyPrime team
Queen's University Belfast · GBOllscoil na Gaillimhe – University of Galway · IETrinity College Dublin · IENIHR Research Delivery Network · GBRoyal College of Surgeons in Ireland · IE

Funding

HSC R&D Division Cross-border Healthcare Intervention Trials in Ireland Network (CHITIN) programme CHI/5431/2018
6 · The paper itself

Abstract

backgroundThe use of multiple medications (polypharmacy) is a concern in older people (≥65 years) and is associated with negative health outcomes. For older populations with multimorbidity, polypharmacy is the reality and the key challenge is ensuring appropriate polypharmacy (as opposed to inappropriate polypharmacy). This external pilot cluster randomised controlled trial (cRCT) aims to further test a theory-based intervention to improve appropriate polypharmacy in older people in primary care in two jurisdictions, Northern Ireland (NI) and the Republic of Ireland (ROI).

methodsTwelve GP practices across NI (n=6) and the six counties in the ROI that border NI will be randomised to either the intervention or usual care group. Members of the research team have developed an intervention to improve appropriate polypharmacy in older people in primary care using the Theoretical Domains Framework of behaviour change. The intervention consists of two components: (1) an online video which demonstrates how a GP may prescribe appropriate polypharmacy during a consultation with an older patient and (2) a patient recall process, whereby patients are invited to scheduled medication review consultations with GPs. Ten older patients receiving polypharmacy (≥4 medications) will be recruited per GP practice (n=120). GP practices allocated to the intervention arm will be asked to watch the online video and schedule medication reviews with patients on two occasions; an initial and a 6-month follow-up appointment. GP practices allocated to the control arm will continue to provide usual care to patients. The study will assess the feasibility of recruitment, retention and study procedures including collecting data on medication appropriateness (from GP records), quality of life and health service use (i.e. hospitalisations). An embedded process evaluation will assess intervention fidelity (i.e. was the intervention delivered as intended), acceptability of the intervention and potential mechanisms of action. DISCUSSION: This pilot cRCT will provide evidence of the feasibility of a range of study parameters such as recruitment and retention, data collection procedures and the acceptability of the intervention. Pre-specified progression criteria will also be used to determine whether or not to proceed to a definitive cRCT.

trial registrationISRCTN, ISRCTN41009897 . Registered 19 November 2019. ClinicalTrials.gov, NCT04181879 . Registered 02 December 2019.

Indexed as

Behaviour changeComplex interventionGeneral practiceOlder peoplePilot studyPolypharmacyPrescribingPrimary careProcess evaluation

Identifiers

PMID33741071
PMCPMC7977311
OpenAlexW3138971821

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.