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

Greiver, M.; Dahrouge, S.; O’Brien, P.; Manca, D.; Lussier, M. T.; Wang, J.; Burge, F.; Grandy, M.; Singer, A.; Twohig, M.; Moineddin, R.; Kalia, S.; Aliarzadeh, B.; Ivers, N.; Garies, S.; Turner, J. P.; Farrell, B.

doi:10.1186/s13012-019-0904-4

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

Back to article page