Rationale and design of OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM): a cluster randomised controlled trial

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dc.contributor.author Adam, Luise
dc.contributor.author Moutzouri, Elisavet
dc.contributor.author Baumgartner, Christine
dc.contributor.author Loewe, Axel Lennart
dc.contributor.author Feller, Martin
dc.contributor.author M'Rabet-Bensalah, Khadija
dc.contributor.author Schwab, Nathalie
dc.contributor.author Hossmann, Stefanie
dc.contributor.author Schneider, Claudio
dc.contributor.author Jegerlehner, Sabrina
dc.contributor.author Floriani, Carmen
dc.contributor.author Limacher, Andreas
dc.contributor.author Jungo, Katharina Tabea
dc.contributor.author Huibers, Corlina Johanna Alida
dc.contributor.author Streit, Sven
dc.contributor.author Schwenkglenks, Matthias
dc.contributor.author Spruit, Marco
dc.contributor.author Van Dorland, Anette
dc.contributor.author Donzé, Jacques
dc.contributor.author Kearney, Patricia M
dc.contributor.author Jüni, Peter
dc.contributor.author Aujesky, Drahomir
dc.contributor.author Jansen, Paul
dc.contributor.author Boland, Benoit
dc.contributor.author Dalleur, Olivia
dc.contributor.author Byrne, Stephen
dc.contributor.author Knol, Wilma
dc.contributor.author Spinewine, Anne
dc.contributor.author O'Mahony, Denis
dc.contributor.author Trelle, Sven
dc.contributor.author Rodondi, Nicolas
dc.date.accessioned 2019-11-20T05:47:39Z
dc.date.available 2019-11-20T05:47:39Z
dc.date.issued 2019-06-03
dc.identifier.citation Adam, L., Moutzouri, E., Baumgartner, C., Loewe, A.L., Feller, M., M’Rabet-Bensalah, K., Schwab, N., Hossmann, S., Schneider, C., Jegerlehner, S. and Floriani, C., 2019. Rationale and design of OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM): a cluster randomised controlled trial. BMJ open, 9(6), (e026769). DOI: 10.1136/bmjopen-2018-026769 en
dc.identifier.volume 9 en
dc.identifier.issued 6 en
dc.identifier.startpage 1 en
dc.identifier.endpage 9 en
dc.identifier.uri http://hdl.handle.net/10468/9136
dc.identifier.doi 10.1136/bmjopen-2018-026769 en
dc.description.abstract Introduction: Multimorbidity and polypharmacy are important risk factors for drug-related hospital admissions (DRAs). DRAs are often linked to prescribing problems (overprescribing and underprescribing), as well as non-adherence with drug regimens for different reasons. In this trial, we aim to assess whether a structured medication review compared with standard care can reduce DRAs in multimorbid older patients with polypharmacy. Methods and analysis: OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people is a European multicentre, cluster randomised, controlled trial. Hospitalised patients ≥70 years with ≥3 chronic medical conditions and concurrent use of ≥5 chronic medications are included in the four participating study centres of Bern (Switzerland), Utrecht (The Netherlands), Brussels (Belgium) and Cork (Ireland). Patients treated by the same prescribing physician constitute a cluster, and clusters are randomised 1:1 to either standard care or Systematic Tool to Reduce Inappropriate Prescribing (STRIP) intervention with the help of a clinical decision support system, the STRIP Assistant. STRIP is a structured method performing customised medication reviews, based on Screening Tool of Older People’s Prescriptions/Screening  Tool to Alert to Right Treatment criteria to detect potentially inappropriate prescribing. The primary endpoint is any DRA where the main reason or a contributory reason for the patient’s admission is caused by overtreatment or undertreatment, and/or inappropriate treatment. Secondary endpoints include number of any hospitalisations, all-cause mortality, number of falls, quality of life, degree of polypharmacy, activities of daily living, patient’s drug compliance, the number of significant drug–drug interactions, drug overuse and underuse and potentially inappropriate medication.Ethics and dissemination: The local Ethics Committees in Switzerland, Ireland, The Netherlands and Belgium approved this trial protocol. We will publish the results of this trial in a peer-reviewed journal.Main funding: European Union’s Horizon 2020 programme.Trial registration number NCT02986425 , SNCTP000002183 , NTR6012, U1111-1181-9400. en
dc.description.sponsorship 6342388 en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group en
dc.relation.uri https://bmjopen.bmj.com/content/9/6/e026769
dc.rights © Author(s) (or their employer(s)) 2019. Published by BMJ en
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/. No commercial re-use en
dc.subject OPERAM en
dc.subject Optimising therapy en
dc.subject Hospital admissions en
dc.subject Europe en
dc.title Rationale and design of OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM): a cluster randomised controlled trial en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Patricia Kearney, Department of Epidemiology and Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: patricia.kearney@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Swiss State Secretariat for Education, Research and Innovation (SERI) en
dc.contributor.funder Horizon 2020 en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMJ Open en
dc.internal.IRISemailaddress patricia.kearney@ucc.ie en
dc.identifier.articleid e026769 en
dc.identifier.eissn 2044-6055


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© Author(s) (or their employer(s)) 2019. Published by BMJ Except where otherwise noted, this item's license is described as © Author(s) (or their employer(s)) 2019. Published by BMJ
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