ArticleJournal of personalized medicine2022
How to Improve Healthcare for Patients with Multimorbidity and Polypharmacy in Primary Care: A Pragmatic Cluster-Randomized Clinical Trial of the MULTIPAP Intervention.
Article in Journal of personalized medicine, 2022. 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 17 papers, 5 of them syntheses that pooled 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.
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
17 citing papers in PubMed, 5 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Optimizing Medication Use in Older Adults in Primary Care: A Systematic Review of the Effectiveness of Deprescribing Interventions.Geriatrics & gerontology international · 2026Pooled it
- Interventions to Address Potentially Inappropriate Prescribing for Older Primary Care Patients: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- Interventions to enhance in-home taking medication among older adults with multimorbidity/polypharmacy: a systematic review and meta-analysis.Frontiers in public health · 2025Pooled it
- Reporting and representation of underserved groups in intervention studies for patients with multiple long-term conditions: a systematic review.Journal of the Royal Society of Medicine · 2024Pooled it
- Interventions to improve the appropriate use of polypharmacy for older people.The Cochrane database of systematic reviews · 2023Pooled it
- 3D-printed polypills for personalized medicine and precision oral drug delivery in pharmaceutical practice: A review.International journal of pharmaceutics: X · 2026Review
- Patient-Centred Care for Multimorbid Patients: A Scoping Review.Journal of clinical medicine · 2026Review
- Training needs and curricular priorities for managing multimorbidity in Spanish primary care: findings from a national exploratory online survey.BMC primary care · 2026Article
- Community-based management strategies for adults with multimorbidity: a systematic review of clinical and patient-centred outcomes.BMJ public health · 2026Article
- Acceptability of Interventions to Address Polypharmacy in Older Adult Outpatients: A Systematic Review and Meta-Analysis.Health science reports · 2025Review
- Applying a co-designed medication plan for safer medication treatment in older persons: a feasibility study.Pilot and feasibility studies · 2025Article
- Defining, identifying and addressing problematic polypharmacy within multimorbidity in primary care: a scoping review.BMJ open · 2024Article
- Measuring Quality of Life in Deprescribing Trials: A Scoping Review.Drugs & aging · 2024Article
- Influence of social determinants of health on quality of life in patients with multimorbidity and polypharmacy.PloS one · 2024Observational
- Older Persons' and Health Care Professionals' Design Choices When Co-Designing a Medication Plan Aiming to Promote Patient Safety: Case Study.JMIR aging · 2023Article
- Is primary care a patient-safe setting? Prevalence, severity, nature, and causes of adverse events: numerous and mostly avoidable.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2023Article
- Recent Updates on Risk and Management Plans Associated with Polypharmacy in Older Population.Geriatrics (Basel, Switzerland) · 2022Article
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 12 institutions in 5 countries.
Funding
Abstract
(1) Purpose: To investigate a complex MULTIPAP intervention that implements the Ariadne principles in a primary care population of young-elderly patients with multimorbidity and polypharmacy and to evaluate its effectiveness for improving the appropriateness of prescriptions. (2) Methods: A pragmatic cluster-randomized clinical trial was conducted involving 38 family practices in Spain. Patients aged 65-74 years with multimorbidity and polypharmacy were recruited. Family physicians (FPs) were randomly allocated to continue usual care or to provide the MULTIPAP intervention based on the Ariadne principles with two components: FP training (eMULTIPAP) and FP patient interviews. The primary outcome was the appropriateness of prescribing, measured as the between-group difference in the mean Medication Appropriateness Index (MAI) score change from the baseline to the 6-month follow-up. The secondary outcomes were quality of life (EQ-5D-5 L), patient perceptions of shared decision making (collaboRATE), use of health services, treatment adherence, and incidence of drug adverse events (all at 1 year), using multi-level regression models, with FP as a random effect. (3) Results: We recruited 117 FPs and 593 of their patients. In the intention-to-treat analysis, the between-group difference for the mean MAI score change after a 6-month follow-up was -2.42 (95% CI from -4.27 to -0.59) and, between baseline and a 12-month follow-up was -3.40 (95% CI from -5.45 to -1.34). There were no significant differences in any other secondary outcomes. (4) Conclusions: The MULTIPAP intervention improved medication appropriateness sustainably over the follow-up time. The small magnitude of the effect, however, advises caution in the interpretation of the results given the paucity of evidence for the clinical benefit of the observed change in the MAI. Trial registration: Clinicaltrials.gov NCT02866799.
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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.