Appropriate polypharmacy in older people in primary care (Version 1.0)
Research type
Research Study
Full title
A pilot cluster randomised controlled trial of a theory-based intervention to improve appropriate polypharmacy in older people in primary care (PolyPrime)
IRAS ID
263668
Contact name
Carmel Hughes
Contact email
Sponsor organisation
Queen's University Belfast
ISRCTN Number
ISRCTN41009897
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Summary of Research
In the past, prescribing many medicines (polypharmacy) was seen in a negative light. However, because people are living longer and have a number of medical conditions at the same time, views on polypharmacy have changed. The challenge is to have the correct balance between many medicines and too many medicines. \n\nMembers of the research team have developed a new approach to achieving this balance. We have tested this approach in two general practices in Northern Ireland (NI). The intervention package currently consists of two parts: (1) a video showing how general practitioners (GPs) can prescribe appropriate polypharmacy for older patients, and (2) an appointment system for patients to visit a GP to have their medicines reviewed. The intervention package was developed and tested in NI, so we need to carry out further testing in NI and the six border counties of the Republic of Ireland (ROI). This will be done in three stages or phases. In phase 1 we have interviewed 13 GPs across 12 practices in the six border counties in the ROI; we have shown them the video, asked them about this new approach and asked if any changes are needed before doing more testing. In the next two phases (Phase 2 & 3) we will carry out a small study involving 12 practices: six practices in NI and six practices in the six border counties in the ROI and approximately 10 patients per practice and interviews with up to 10 GPs and patients respectively in the six intervention arm practices at the end of the intervention. This will allow us to test and compare the delivery of the intervention across NI and the ROI and to decide whether to progress to a full-scale randomised trial at a later date.Summary of Results
Twelve GP practices were recruited and randomised. Three GP practices withdrew from the study due to COVID-related factors. Sixty-eight patients were recruited, with 47 (69.1%) remaining until the end of the study.
GP record information was available for 47 patients for medication appropriateness analysis at 9 months. Health-related quality of life information was available for 46 and 41 patients, respectively, at 9 months. GP record information and patient information on how often patients used the health service were available for 47 patients at 9 months. The intervention which was focussed on better prescribing of medicines was successfully delivered as intended; it was acceptable to GPs, practice staff, and patients.REC name
North of Scotland Research Ethics Committee 1
REC reference
19/NS/0100
Date of REC Opinion
3 Jun 2019
REC opinion
Favourable Opinion