Please select the eligibility criteria that correspond to the clinical trial below.
Title: Optimizing PharmacoTherapy In the Multimorbid Elderly in Primary CAre: a Cluster Randomized Controlled Trial (the OPTICA Trial)
Brief Summary: The objective of this randomized controlled trial (RCT) is to evaluate whether the Systematic Tool to Reduce Inappropriate Prescribing (STRIP), put into practice through the STRIP Assistant (STRIPA) and implemented by general practitioners (GPs), will lead to an improvement in clinical and economic outcomes in patients aged 65 or older with multimorbidity and polypharmacy.


Options:
A: Inclusion Criteria:

* Age greater than or equal to 65
* Resident in EHPAD
* presenting a high iatrogenic drug risk (Trivalle score between 6-10).
* Ability to provide free, informed and express consent (patient and / or trusted person)
* Affiliated to a social security scheme

Exclusion Criteria:

* Patient with a life expectancy \<3 months
* Patient under 65 years
* Trivale score \<6
* Vulnerable persons within the meaning of French law (adults under guardianship or trusteeship, persons deprived of their liberty)
* Participation in another research protocol in progress
* Patient who has had a medication review (or medication review) known in the last 6 months.
* Patient with severe dementia (MMSE \<18)
B: Inclusion Criteria

* Being a regular patient of participating GP
* Age: 65 years of age or older
* Multimorbidity: 3 or more coexistent chronic conditions defined by 3 distinct International Classification in Primary Care -2 (ICPC-2) codes defined as chronic (O'Halloran et al., 2004) with an estimated duration of 6 months or more, or based on a clinical decision supported by Pharmacost Groups (PCG) for chronic conditions in an algorithm from FIRE
* Polypharmacy: Use of five or more different regular drugs (defined as authorized medications with registration numbers) for more than 30 days before signing the informed consent form

Exclusion Criteria

* Inability to provide informed consent from a patient or to obtain informed consent from a proxy for patients with cognitive impairment
* If the patient is already participating in the a different interventional study
C: For interview questionnaire:

Inclusion criteria are:

1. Accepted informed consent,
2. The healthcare professional is practicing in the involved nursing homes.

Exclusion criteria are:

1) Decline/unable to provide consent.

For team-care deprescribing study:

Inclusion criteria are:

1. Accepted informed consent (unless cognitive-impaired, with no or un-contactable next-of-kin),
2. Adult aged 65 years and above,
3. Currently on five or more medications.

Exclusion criteria are:

1. Below the age of 65 years of age,
2. Life expectancy of less than 6 months or respite care.
D: Inclusion Criteria:

* All patients admitted to the wards during week days after decision of a ward physician or nurse if the medical condition allows inclusion

Exclusion Criteria:

* Exclusion criteria are poor Swedish language and planned discharge before the intervention can be performed.
* Patients transferred to wards not belonging to the department of medicine or other hospitals during the hospital stay are also excluded.

Answer: B