Appropriate Prescribing for older adults with Multimorbidity (Pro-M): protocol for a feasibility study

Autor: Jia Ying Tang, Poh Hoon June Teng, Christine Yuanxin Chen, Keng Teng Tan, Wendy Ang, Sabrina Lau, Alexis Guat Cheng Ang, Kay Khine Kyaw, Xin Yong Tay, Wan Min Stephanie Lim, Wrenzie Del Valle Espeleta, Huimin Lin, Yew Yoong Ding, Penny Lun
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Archives of Public Health, Vol 82, Iss 1, Pp 1-8 (2024)
Druh dokumentu: article
ISSN: 2049-3258
DOI: 10.1186/s13690-024-01264-x
Popis: Abstract Background Potentially inappropriate prescribing is common among older adults with multimorbidity due to various reasons, from concurrent application of multiple single-disease clinical guidelines to fragmentation of care. Interventions such as medication review have been implemented worldwide to reduce inappropriate prescribing for older adults. However, the implementability of such interventions are underexplored in the outpatient clinics in Singapore’s public hospitals. Hence, the Pro-M study aims to assess the feasibility of implementing a physician-pharmacist collaborative care intervention in geriatric medicine outpatient clinics to facilitate appropriate prescribing for older adults in Singapore. Methods This is a single-arm, non-randomised feasibility study using a pre-post evaluation design. This study consists of two parts: (1) implementation phase of the intervention (6 months) and an (2) evaluation phase (3 months). Eligible patients will be recruited from geriatric medicine outpatient clinics at two public hospitals in Singapore through convenience sampling. The main components of the Pro-M intervention are: (1) pharmacist-facilitated medication reviews with feedback on any medication issues and potential recommendations to physicians, and (2) physicians communicating changes to other relevant prescribers. The evaluation phase will involve surveying and interviewing physicians and pharmacists involved in the implementation of the intervention. A mixed-method approach will be employed for data collection and analysis. The quantitative and qualitative findings will be triangulated and reported using Proctor’s implementation outcomes: appropriateness, penetration, acceptability, fidelity, feasibility, and sustainability. A basic cost analysis will be conducted alongside the study. Discussion This is a phase 2 study to test the feasibility of implementing an intervention that was co-created with stakeholders during phase 1 development of an intervention to optimise prescribing for older adults with multimorbidity. The implementation will be assessed using Proctor’s implementation outcomes to provide insights on the process and the feasibility of implementing medication reviews for older adults with multimorbidity as a routine practice in outpatient clinics. Data collected from this study will inform a subsequent scale-up study. Trial registration ClinicalTrials.gov Identifier: NCT05756478. Registered on 06 March 2023.
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