A feasibility study on collaborative medication review for multimorbidity in primary care

• Register: ISRCTN
• Last refreshed on: 5 June 2017
• Main ID: ISRCTN34837446
• Date of registration: 06/10/2015
• Prospective Registration: No
• Primary sponsor: Department of General Practice
• Public title: A feasibility study on collaborative medication review for multimorbidity in primary care
• Scientific title: A feasibility study on the MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE) intervention in general practice
• Date of first enrolment: 26/11/2014
• Target sample size: 20
• Recruitment status: Completed
• URL: http://isrctn.com/ISRCTN34837446
• Study type: Interventional
• Study design: Non-randomised feasibility study (Treatment)

Countries of recruitment

Ireland

Contacts

• Name: Carol Sinnott

Key inclusion & exclusion criteria

Inclusion criteria: 1. General Practitioners (GPs)
2. Working in practices with two or more GPs employed
Exclusion criteria: N/A

Age minimum:
Age maximum:
Gender: Both

Health Condition(s) or Problem(s) studied

Multi-morbidity
Signs and Symptoms
Multi-morbidity

Intervention(s)

Participating GPs selected patients prescribed more than 10 medications, or more than 4 medications with a complicating factor, on which to conduct a collaborative medication review. After one month GPs are interviewed to study their experience of the intervention, referring specifically to implementation outcomes stated in the WHO Implementation of Innovations in Practice framework.

MY COMRADE intervention:
1. Prompts: A checklist was provided as a guide for the medication review. The checklist was based on the NO TEARS checklist, a pragmatic and practical set of seven questions which relate to safe prescribing and can be applied to any medication. The original NO TEARS checklist was designed for use between GP and patient – we modified it for use between two GPs in order to guide and frame the medication review. The GPs were instructed to note any potential changes to medications on the checklist page, and scan it into the patient’s notes to make the next review easier and serve as a record of the medication review process. The set of prescribing questions (prescribing tool) was offered to GPs in paper or electronic format, and participating GPs chose the format most convenient for their practice.
2. Social support: The principal component of the intervention is that GPs act in a collaborative fashion, with at least 2 GPs reviewing the medications for each multi-morbid case chosen. GPs were asked to each choose 3 patients on which to do the medication review (10+ medications or 5+ medications with another complicating factor such as dementia, poor life expectancy etc.), and schedule a time to discuss these patients with another GP in their practice.
3. Change in social environment: The GPs were asked to schedule protected time for themselves in which to conduct the medication review. This would involve them moving to one consultation room to avail of medical records for the cases that were chosen.
4 .Self-incentives (CPD points) they were advised that once the

Primary Outcome(s)

Success of the intervention in achieving behavioural change (i.e. medication review by GPs) measured in evaluation interviews, one month after the start of the intervention.

Secondary Outcome(s)

Implementation outcome variables, measured using the WHO implementation of innovations in practice framework, one month after the start of the intervention.

Secondary ID(s)

N/A

Source(s) of Monetary Support

Health Research Board