A tailored implementation intervention to implement recommendations addressing polypharmacy in multimorbid patients:...

Area of Science:

• Primary care research
• Implementation science
• Pharmacotherapy

Background:

• Multimorbid patients often have complex medication regimens, increasing risks of adverse drug reactions and hospitalizations.
• Managing polypharmacy is challenging due to multiple prescribers and intensive monitoring needs.
• Evidence-based recommendations for polypharmacy (counselling, lists, reviews) are underimplemented in German primary care.

Purpose of the Study:

• To examine a tailored intervention for implementing polypharmacy recommendations in German primary care practices.
• To assess the feasibility of tailored interventions for guideline implementation.
• To contribute to the European Tailored Interventions for Chronic Diseases project.

Main Methods:

• Cluster randomized controlled trial with primary care practices organized in quality circles.
• Intervention group: GPs and assistants receive training; tailored implementation concept; checklists; patient educational tools.
• Control group: usual care. Primary outcome: degree of implementation of three recommendations. Secondary outcomes: PIM prescription rate, patient activation, beliefs, adherence, social support.

Main Results:

• The primary outcome is the degree of implementation of the three recommendations.
• Secondary outcomes include potentially inappropriate medication (PIM) prescription rates, patient activation, beliefs about medicine, medication adherence, and social support.

Conclusions:

• This study will provide insights into the feasibility of implementing polypharmacy management recommendations in primary care.
• The research will also advance understanding of tailoring methods for implementation interventions.