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Allgemein- und Familienmedizin

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PARTNER - Co-operation between GP practices and pharmacies to improve medication safety with multi-medication


Acronym: PARTNER

Study design: Multicentre cluster-randomised study

Duration: 01.06.2022 until 31.05.2025

Status: Ongoing

Ethics vote: Ethics Committee of the Westphalia-Lippe Medical Association and the Westphalian Wilhelms University, file number: 2022-774-b-S

Funding: Innovation fund of the Federal Joint Committee (01VSF21038); no funding from the pharmaceutical industry or medical device manufacturers

Team location Bielefeld:

  • Project leader: Svetlana Puzhko, MD, PhD
  • Research assistant: Kerstin Bernartz, M. Sc. Public Health
  • Study assistants: Stephanie Picker-Huchzermeyer, Helga Nolte

Background:

Multimedication, or “polypharmacy” (taking 5 or more medications) is common for patients with multimorbidity. However, the use of multiple medications may increase the risk of adverse drug reactions, especially in older patients. Guidelines therefore recommend carrying out a medication analysis at least once a year in order to review indications, recognise risks and ensure adequate self-management. Medication analyses, however, are often complex and time-consuming. Therefore, a joint work of GPs and pharmacists may help optimize medication safety. Mutual productive work of GPs and pharmacists is a well-structured process and can be reached by coordinated efforts.

Research question:

Can the PARTNER intervention increase medication safety in older people with multimedication (polypharmacy) compared to extended routine care?

Project description:

We are conducting a multi-centre, two-arm, cluster-randomised study. The project is accompanied by a health economic evaluation and a process evaluation. Cluster-randomised means that practices and pharmacies are randomly assigned to the intervention or control group. One cluster consists of one GP practice and one or more pharmacies. All associated study patients are treated according to group status.

The study will include at least 45 GP practices and 352 patients with polypharmacy and potentially inappropriate medications (approx. 5 to 8 patients per practice). The patients should be 65 years old or older. There are three study sites. The recruitment was started in December 2022, after approval by the ethics committee.

The PARTNER intervention includes the following:

  1. A joint case conference between a general practitioner and a pharmacist on a study patient's list of medications.
  2. Informative and motivating counselling study patients by the pharmacist.
  3. Making a joint decision by the general practitioner and the patient to change or maintain the medication.

In the control group, a medication review by the pharmacy is planned. In addition, the study patients in both groups will receive regular care at their GP practice.

The primary endpoint measures whether the study patients in the intervention group take less inappropriate medications than the study patients in the control group. Aspects of the well-being of study patients will be surveyed for other endpoints.

External project partners:

  • Munich University Hospital, Institute of General and Family Medicine, Chair of Clinical Health Services Research (Prof. Dr Tobias Dreischulte; consortium leader)
  • University of Witten/Herdecke, Faculty of Health, Institute of General Medicine and Ambulatory Health Care (IAMAG), Chair of General Medicine II and Patient Orientation in Primary Care (Prof. Dr Achim Mortsiefer)
  • Heidelberg University Hospital, Clinical Pharmacy Cooperation Unit (Prof. Dr Hanna Seidling)
  • aQua - Institute for Applied Quality Promotion and Research in Healthcare GmbH (Dr Petra Kaufmann-Kolle, Patrizio Vanella)
  • University Hospital Regensburg, Centre for Clinical Studies (Prof. Dr Michael Koller)
  • Techniker Krankenkasse, Hamburg

Data sharing guidelines:

After completion of the study, the data will be stored in the institutional repository of Bielefeld University PUB in accordance with the Bielefeld Resolutions on Open Access.

If you are interested in participating in the study or have any questions, please contact us - by email at projekt-partner@uni-bielefeld.de or by telephone on +49 (0)521 / 106 86818

Keywords: Multimedication, polypharmacy, medication safety, doctor-pharmacist cooperation, misuse and overuse, quality of pharmaceutical care, interprofessional cooperation, health services research

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