Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polyph
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Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy: study protocol of a cluster randomized clinical trial (Multi-PAP project) Alexandra Prados-Torres1,2,3,4*, Isabel del Cura-González3,5,6, Daniel Prados-Torres7,8,9, Juan A. López-Rodríguez3,5,6,10, Francisca Leiva-Fernández7,8,9, Amaia Calderón-Larrañaga1,3,4,11, Fernando López-Verde12, Luis A. Gimeno-Feliu2,3,13, Esperanza Escortell-Mayor3,5, Victoria Pico-Soler3,14, Teresa Sanz-Cuesta3,5, Mª Josefa Bujalance-Zafra15, Mariel Morey-Montalvo3,5, José Ramón Boxó-Cifuentes16, Beatriz Poblador-Plou1,3,4, José Manuel Fernández-Arquero17, Francisca González-Rubio3,18, María D. Ramiro-González19, Carlos Coscollar-Santaliestra3,13, Jesús Martín-Fernández3,6,20, Mª Pilar Barnestein-Fonseca8,9, José María Valderas-Martínez21, Alessandra Marengoni22, Christiane Muth23 and Multi-PAP Group
Abstract Background: Multimorbidity is associated with negative effects both on people’s health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12 months, as compared with usual care. (Continued on next page)
* Correspondence: [email protected] 1 Instituto Aragonés de Ciencias de la Salud (IACS), IIS Aragón, Hospital Universitario Miguel Servet, Paseo Isabel La Católica 1-3, 50009 Zaragoza, Spain 2 Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain Full list of author information is available at the end of the article © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Prados-Torres et al. Implementation Science (2017) 12:54
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