Please select the eligibility criteria that correspond to the clinical trial below.
Title: Cooperation for Improved Pharmacotherapy in Home-dwelling Elderly People Receiving Polypharmacy - The COOP Study
Brief Summary: Polypharmacy increases the risk of adverse drug effects, interactions and other drug-related problems, and several studies indicate that inappropriate drug use is a major reason for poor health and impaired function in the elderly. A majority of interventions for improvement of drug treatment in the elderly have been evaluated by the use of surrogate outcomes such as drug-related problems, number of prescribed drugs or prevalence of potentially inappropriate prescriptions - and it is so far unclear whether such interventions can result in clinical significant improvements. The primary objective of this trial is therefore to evaluate the effect upon patients, relatives and local health care service of a structured cooperation between a hospital-based geriatrician and family physicians on complex drug regimens in home-dwelling frail elderly patients.


Options:
A: Inclusion Criteria:

* Any community-dwelling patient of McMaster Family Health Team over the age of 70

Exclusion Criteria:

* Patient is palliative or receiving end-of-life care
* Patient is deceased
* Has explicitly stated that they do not want to be part of a research project
* Patient resides in long-term care
* Patient has indicated that they do not want to receive a home visit from trained community volunteers.
* Patient or family member does not speak English
* Patient will be out of the country for more than 50% of trial duration
B: Inclusion Criteria:

* 65 years old or older
* Annual income less than 200% of the federal poverty level
* Have had one or more primary care visits in the past 12 months
* Reside in the community (non-institutionalized)

Exclusion Criteria:

* Non-English speaking
* No regular access to a telephone
* Currently undergoing kidney dialysis treatments
* Residing with a patient already participating in the GRACE clinical trial
C: Inclusion Criteria:

* The patient must be on the list of one of the family physicians participating in the study
* Home dwelling (not permanently institutionalised)
* Medications administered by the home nursing service
* Polypharmacy defined as the use of at least seven different systemic medications taken regularly
* Informed consent by the patient or a close relative

Exclusion Criteria:

* Patient or relative denies inclusion
* The family physician does not want the particular patient to participate
* Moderate/severe dementia (Clinical Dementia Rating Scale score \> 1) and contact with the closest proxy less than once every other week.
* The patient does not speak/understand Norwegian
* Expected to become permanently institutionalised within six months
* Life expectancy \< six months
D: Inclusion Criteria:

The inclusion criteria for this trial were the "frail elderly" defined as:

* community-dwelling persons aged \> 75 years,
* having more than three chronic diagnoses,
* prescribed six or more pharmaceutical drugs for continuous use and
* with at least three hospital stays (\> 24 hours in hospital) during the last six months.

Since these criteria were broad in order to capture relevant individuals, but also likely to generate persons of no relevance to the MGT intervention, identification of the study sample was conducted in three steps, in turn, repeated in three waves.

Exclusion Criteria:

* Persons not able to take part in qualitative interviews

Answer: C