Inappropriate Polypharmacy in Elderly Patients in Primary Care and Deprescribing in Older Patients With Frailty
NCT Number: NCT06470308
Status: NOT_YET_RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Medication Overuse|Deprescriptions|Polypharmacy|Frailty Syndrome
Interventions: OTHER: Medication Reviews and Deprescribing
Sponsor: University of Crete
Sex: ALL
Age: OLDER_ADULT
Enrollment: 310
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: OTHER
Start Date: 2024-07
Completion Date: 2025-08

Summary:
Polypharmacy is a major and growing public health problem occuring within all health care settings worldwide. The systematic review of Mansoon et al,2017 identified 138 different definitions for polypharmacy from which the most commonly used numerical definition is being this of five or more medicines. However, numerical definitions do not take into account factors such as comorbidity thus there is a need for a a shift towards the terms "appropriate" ,and "inappropriate polypharmacy" and potentially inappropriate prescribing (PIP). The prevalence of polypharmacy varies between 10% to as high as around 90% depending on the definition used and the population that is studied.There is worldwide literature regarding the epidemiology of polypharmacy in the elderly , health outcomes and cost. The is an abundance of guidelines and tools regarding deprescribing, the process of withdrawal of an inappropriate medication, supervised by a health care professional with the goal of managing polypharmacy , minimizing inappropriate medication and improving outcomes. In Greece , as pointed out by the SIMPATHY project, there is no formal polypharmacy initiative and relative greek literature is scarce.There is no research in Greece regarding the prevalence of PIP among community-dwelling elderly patients as well as there are no studies evaluating the feasibility or effectiveness of deprescribing interventions in the elderly or older patients with frailty.

The aim of this thesis is to record, in the primary care setting in Crete, the underlying barriers and enablers of deprescribing among health care professionals and also to evaluate ,the clinical outcomes of deprescribing interventions in primary care. Additionally, the beliefs and attitudes of the patients and/or their caregivers towards deprescribing will be recorded.

Primary Outcome Measures: Potentially Inappropriate Medication, Determine if there is reduction in potentially Inappropriate medication after a deprescribing education intervention, 1 years
Secondary Outcome Measures: Health-Related Quality of Life, Evaluate if there is change in Health-Related Quality of Life using a validated questionnaire, 1 year|Medication adherence, Evaluate if there is change in medication adherence using a validated questionnaire, 1 year|Frailty Status, evaluation of frailty using a validated score, 1 year|Cognitive impairment, evaluation of cognitive impairment using a validated questionnaire, 1 year|Depression, evaluation of geriatric depression using a validated questionnaire, 1 year|Fear of falling, Evaluate if there is change in fear of falling using a validated questionnaire, 1 year