Trial reportPloS one2022
Cost-effectiveness of a structured medication review approach for multimorbid older adults: Within-trial analysis of the OPERAM study.
Trial report in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Mapping to estimate health state utility: a systematic review of development and limitations.Health and quality of life outcomes · 2025Pooled it
- Cost effectiveness of a GP delivered medication review to reduce polypharmacy and potentially inappropriate prescribing in older patients with multimorbidity in Irish primary care: the SPPiRE cluster randomised controlled trial.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Trial
- Optimising prescribing in older adults with multimorbidity and polypharmacy in primary care (OPTICA): cluster randomised clinical trial.BMJ (Clinical research ed.) · 2023Trial
- Development and Temporal Validation of Machine Learning Models for Hyponatremia Risk in Community-Dwelling Older Adults: A Nationwide Claims-Based Study.Journal of clinical medicine · 2026Article
- Multimorbidity Management: A Scoping Review of Interventions and Health Outcomes.International journal of environmental research and public health · 2025Article
- The association between medication use and health-related quality of life in multimorbid older patients with polypharmacy.European geriatric medicine · 2024Article
- Developing Medication Reviews to Improve the Aruban Healthcare System: A Mixed-Methods Pilot Study.Pharmacy (Basel, Switzerland) · 2024Article
- Structured medication reviews for adults with multimorbidity and polypharmacy in primary care: a systematic review protocol.BMJ open · 2024Article
- Association of medication use with falls and mortality among long-term care residents: a longitudinal cohort study.BMC geriatrics · 2023Article
- Healthcare Costs and Health-Related Quality of Life in Older Multimorbid Patients After Hospitalization.Health services insights · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 7 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInappropriate polypharmacy has been linked with adverse outcomes in older, multimorbid adults. OPERAM is a European cluster-randomized trial aimed at testing the effect of a structured pharmacotherapy optimization intervention on preventable drug-related hospital admissions in multimorbid adults with polypharmacy aged 70 years or older. Clinical results of the trial showed a pattern of reduced drug-related hospital admissions, but without statistical significance. In this study we assessed the cost-effectiveness of the pharmacotherapy optimisation intervention.
methodsWe performed a pre-planned within-trial cost-effectiveness analysis (CEA) of the OPERAM intervention, from a healthcare system perspective. All data were collected within the trial apart from unit costs. QALYs were computed by applying the crosswalk German valuation algorithm to EQ-5D-5L-based quality of life data. Considering the clustered structure of the data and between-country heterogeneity, we applied Generalized Structural Equation Models (GSEMs) on a multiple imputed sample to estimate costs and QALYs. We also performed analyses by country and subgroup analyses by patient and morbidity characteristics.
resultsTrial-wide, the intervention was numerically dominant, with a potential cost-saving of CHF 3'588 (95% confidence interval (CI): -7'716; 540) and gain of 0.025 QALYs (CI: -0.002; 0.052) per patient. Robustness analyses confirmed the validity of the GSEM model. Subgroup analyses suggested stronger effects in people at higher risk.
conclusionWe observed a pattern towards dominance, potentially resulting from an accumulation of multiple small positive intervention effects. Our methodological approaches may inform other CEAs of multi-country, cluster-randomized trials facing presence of missing values and heterogeneity between centres/countries.
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