Optimising Medication With Focus on Deprescribing in Frail Older People With Multidose Drug Dispensing Systems

NCT05609981 | Completed

• 2 other identifiers: UPF221180-86600-98-19512
• Study Type: interventional
• Target: 318
• Locations: 1 country
• Sites: 1

Brief Summary

Overuse is common in frail older people with polypharmacy, especially in frail older users of multidose drug dispensing (MDD) systems. In this study, we will investigate the effect of a clinical medication review (CMR) with integration of deprescribing (toolbox) on the number of ceased and dose lowered medications (persistent after 6 months) compared to usual care in older users of MDD systems with hyperpolypharmacy. We will perform a controlled cluster-randomized trial in 38 community pharmacies. Per pharmacy, 10 older patients (\>= 75) with hyperpolyfpharmacy (\>10 medicines in use) with a MDD will be included. Pharmacists will receive training to perform the intervention, a 5-step CMR with a deprescribing toolbox (including deprescribing protocols): 1) patient interview; 2) pharmacotherapeutic analysis; 3) pharmacist and GP discuss actions; 4) actions are discussed with patient; 5) (two)weekly follow-up.

Conditions

Deprescriptions; Polypharmacy; Primary Health Care; Community Pharmacy Services

Outcome Measures

Primary Outcomes (1)

• number of ceased or dose lowered drugs per patient

  number of ceased or dose lowered drugs per patient based on dispensing data

  6 months after the start of the medication review (t = 6 months)

Study Arms (2)

Intervention

OTHER

The intervention at t=0 consists of a 5-step patient-centred CMR focused on deprescribing supported by a toolbox provided to the pharmacists

Other: Clinical medication review focused on deprescribing

Control

NO INTERVENTION

Usual care.

Interventions

Clinical medication review focused on deprescribing OTHER

A pharmacist-led intervention consisting of a clinical medication review with the focus on deprescribing in older patients using multidose drug dispensing (MDD) systems. Pharmacist are trained in deprescribing and a developed toolbox to support the intervention is provided

Intervention

Eligibility Criteria

• Age: 75 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• using a multidose drug dispensing system
• hyperpolypharmacy patient (using 10 drugs or more)
• age: 75 years or older

You may not qualify if:

• received a CMR in the previous 12 months
• incapacitated
• patients for whom the general practitioner is not the primary practionar
• expected lifespan of less than six motnhs
• patients who live in a nursing home

Sponsors & Collaborators

• SIR Institute for Pharmacy Practice and Policy: lead

Study Sites (1)

SIR Institute for Pharmacy Practice and Policy

Leiden, South Holland, 3604DP, Netherlands

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 2, 2022
• First Posted: November 8, 2022
• Study Start: November 10, 2022
• Primary Completion: February 21, 2025
• Study Completion: June 27, 2025
• Last Updated: July 31, 2025

Record last verified: 2025-07

Locations

NL (1)