OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly

Schrift Standard Fett
Login

Forschungsstelle

SBFI

Projektnummer

15.0137-1

Projekttitel

OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly

Texte zu diesem Projekt

	Deutsch	Französisch	Italienisch	Englisch
Abstract	-	-	-

Erfasste Texte

Kategorie	Text
Abstract (Englisch)	Most older adults have multiple chronic diseases (multimorbidity) and multiple medications (polypharmacy).\nHowever, multimorbid patients are often excluded from clinical trials and most guidelines address diseases in\nisolation. Inappropriate drug prescription and poor drug compliance are common and contribute to up to 30% of\nhospital admissions. OPERAM investigators developed STOPP/START criteria to detect inappropriate drug use,\nboth over- and underuse. Applying these criteria limits unnecessary polypharmacy and reduces underuse of indicated\nmedications, but it remains uncertain whether systematic pharmacotherapy optimisation can improve clinical\noutcomes and reduce costs.We propose a multicentre randomised controlled trial to assess the impact of a userfriendly\nsoftware-assisted intervention to optimise pharmacotherapy and to enhance compliance in 1900 multimorbid\npatients aged =75 years. Outcomes will include drug-related hospital admissions, health care utilisation, quality of life,\npatient preferences and cost-effectiveness. We will also perform several network meta-analyses (NMA) to provide\nnew comparative evidence on the most effective and safest pharmacological and non-pharmacological interventions\nto reduce common causes of preventable hospital admissions (e.g. falls, fractures, bleeding). Therapy optimisation in\nthe multimorbid elderly, enhanced compliance and discontinuation of less effective interventions have the potential\nto improve clinical, quality of life and safety outcomes, while reducing costs. We will provide a structured method\nwith practical software solutions for optimal prescribing and new comparative evidence from NMAs for addressing\nmultimorbidity and polypharmacy by means of customised, patient-centred guidelines. OPERAM ultimately aims\nat better healthcare delivery in primary and hospital care, based on effective, safe, personalised and cost-effective\ninterventions that can be applied to the rapidly growing older population in Europe.

Kategorie

Text

Abstract
(Englisch)

Most older adults have multiple chronic diseases (multimorbidity) and multiple medications (polypharmacy).\nHowever, multimorbid patients are often excluded from clinical trials and most guidelines address diseases in\nisolation. Inappropriate drug prescription and poor drug compliance are common and contribute to up to 30% of\nhospital admissions. OPERAM investigators developed STOPP/START criteria to detect inappropriate drug use,\nboth over- and underuse. Applying these criteria limits unnecessary polypharmacy and reduces underuse of indicated\nmedications, but it remains uncertain whether systematic pharmacotherapy optimisation can improve clinical\noutcomes and reduce costs.We propose a multicentre randomised controlled trial to assess the impact of a userfriendly\nsoftware-assisted intervention to optimise pharmacotherapy and to enhance compliance in 1900 multimorbid\npatients aged =75 years. Outcomes will include drug-related hospital admissions, health care utilisation, quality of life,\npatient preferences and cost-effectiveness. We will also perform several network meta-analyses (NMA) to provide\nnew comparative evidence on the most effective and safest pharmacological and non-pharmacological interventions\nto reduce common causes of preventable hospital admissions (e.g. falls, fractures, bleeding). Therapy optimisation in\nthe multimorbid elderly, enhanced compliance and discontinuation of less effective interventions have the potential\nto improve clinical, quality of life and safety outcomes, while reducing costs. We will provide a structured method\nwith practical software solutions for optimal prescribing and new comparative evidence from NMAs for addressing\nmultimorbidity and polypharmacy by means of customised, patient-centred guidelines. OPERAM ultimately aims\nat better healthcare delivery in primary and hospital care, based on effective, safe, personalised and cost-effective\ninterventions that can be applied to the rapidly growing older population in Europe.