Please select the eligibility criteria that correspond to the clinical trial below.
Title: Clinical and Economical Assessment of an Intervention to Reduce Potentially Inappropriate Medication in Polymedicated Elderly Patients
Brief Summary: Objective: To evaluate the clinical and economic impact of the application of an algorithm to improve the adequacy and safety of pharmacotherapy in elderly polymedicated (receiving 8 or more medications), not institutionalized.

Design: randomized, open, multicenter and two branches of parallel intervention clinical trial.

Intervention Study: primary care pharmacist apply the GP-GP algorithm to each drug with the support of STOPP criteria, Beers and / or recommendations CatSalut. The pharmacist submit to doctor his findings and reach a consensus and decide which recommendations will be presented to patient. Control intervention: usual procedure.

Main outcome measures: a) Discontinued medications, changed or changing doses, b) GP consultations, hospital emergency department and hospital admissions for acute illness, c) pharmaceutical expenditure, d) restart medication e) complications underlying diseases. Follow-up control at 1 month (security) and at 3, 6 and 12 months.


Options:
A: Inclusion Criteria:

* Patients with polypharmacy (5 or more medicines)
* That detects to them a problem of Therapeutic Adherence
* That agree to take part in the study

Exclusion Criteria:

* Immobilized patients or with an index of Barthel lower than 60 points
* Incapable to fulfill ABVD
* Patients with cognitive deterioration
* Patients with diagnosis of ictus in the last 6 months
* That has been admitted to hospital 2 or more times in the last year Institutionalized patients
B: Inclusion criteria:

* Nursing homes within pre-determined regions of Ontario that expressed an interest in the full intervention (the regions, or hubs, contain a wide variety of nursing home types within a reasonable travel distance \[i.e., \<100 km\])
* Nursing homes within the hubs in which the medical and administrative leads agree to and support the project

Exclusion criteria:

* Nursing homes with a previous or ongoing involvement in externally supported quality improvement initiatives focusing on antipsychotic medications
* Nursing homes without any prescribers caring for at least 10 residents routinely
* Nursing homes with fewer than 30 residents
C: Inclusion Criteria:

* 18-years old or older;
* have a diagnosis of diabetes mellitus either by ICD-billing codes or indicative medications;
* are prescribed at least (3) chronic condition medications according to the EHR medication list;
* are English or Spanish-speaking;
* have no imminent intention to move or change clinics within the next year;
* score 4 or higher on the six-question screener based on the Mini-Mental Status Exam;
* are primarily responsible for administering their own medications;
* prescribed a new chronic condition medication (including refills, and change in titrations) during their clinic visit and day.

Exclusion Criteria:

* under age of 18 years-old;
* does not speak English or Spanish;
* dependent on assistance for medication administration;
* scored less than 4 on the six-question screener;
* not prescribed a new medication or changed medication at clinical appointment;
D: Inclusion Criteria:

* 70 years or more
* Currently receiving eight or more drugs, except ointments and administered via topical nonprescription
* Give their informed written consent to participate in the study.

Exclusion Criteria:

* Estimated life expectancy less than 6 months.
* Active cancer
* Participation in any other clinical trial or program for evaluation of medication in the elderly.
* Institutionalized in nursing homes.
* Surgical intervention scheduled for the next 6 months

Answer: D