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Table 2 Summary of outcomes (RCT phase)

From: Improving care for elderly patients living with polypharmacy: protocol for a pragmatic cluster randomized trial in community-based primary care practices in Canada

Dimension/measure Target population Assessment Time
Health outcomes
 Primary outcome: PIP prevalence:
Absolute reduction in the prevalence of PIPs, defined as # PIP in target population/# patients in target population
All individuals (intervention and control):
• Member of the practice of a participating provider; 65 and over; with 10 + prescription in previous 12 months
Post-intervention only: All patients identified at pre-intervention, alive, and member of the practice. New patients meeting criteria may enter the cohort
EMR data extraction
See operationalizing this indicator in Additional file 4
Baseline: prevalence of PIPs during the 12 months prior to the start of the intervention
Post-intervention: prevalence of PIPs during the 12 months following the intervention
 Patient prevalence:
Absolute reduction in number of patients with at least one PIP
As above As above As above
 Quality of life A 10% randomly selected subset of individuals identified at baseline as having at least one PIP (intervention and control) EuroQOL-5D [111] Post-intervention
Patient experience
 Medication-related experience Same as above Survey adapted from the Veterans Affairs multidimensional survey [59, 106] Post-intervention
 Experience with care Same as above but in the intervention arm only Semi-structured interviews Post-intervention
Provider experience
 Experience in Collaborative and in deprescribing PIPs All PCPs in the intervention arm only will be invited Survey adapted from existing tools [112, 113] Post-intervention
 Experience in Collaborative and in deprescribing PIPs At least one PCP from each practice in the intervention arm only will be invited Focus groups Post-intervention
Costs
 Cost-benefit All individuals identified at baseline as eligible (intervention and control), in Ontario only Health administrative data Post-intervention, end of follow-up period (12 months after intervention completed)
Estimate of costs of medication, delivering the enhanced QI program (materials, management costs for the program, EMR data extraction and analysis), and practice facilitation All practices and patients in intervention arm only Program manager logs and records Post-intervention