Models for Caring for Patients with Complex Lifestyle, Medical, and Social Needs

Medication optimisation in hospitalised older people with polypharmacy and multimorbidity

“…Hence, the uncertainty of the effectiveness of medication reviews in older people with polypharmacy and multimorbidity on clinical outcomes was the rationale to design a large, randomised controlled trial explicitly addressing the limitations of previous trials. The aim of the OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM) trial assessed the effectiveness of an in-hospital structured medication review compared to usual care on drugrelated hospital admissions and other clinical outcomes, using a core outcome set previously developed by European healthcare professionals and patients [85,86]. A detailed evaluation of the different steps of this in-hospital medication review could provide relevant insights to optimise this complex process.…”

“…This research is part of the OPERAM trial, a European cluster-randomised controlled multicentre trial investigating the effect of a STOPP/START-based in-hospital medication review on drug-related readmissions in older (≥ 70 years) patients with multimorbidity (≥3 chronic conditions) and polypharmacy (≥5 regular medication use). Secondary outcomes are based on the aforementioned core outcome set [85]. The in-hospital medication review is performed according to the STRIP method supported by STRIPA software with incorporated STOPP/START version 2.…”

“…Key factors in this programme were an integrated approach to care, a trusted physician-patient relationship, ready access to outpatient care, and a proactive interdisciplinary team tailored to patient needs. The preliminary findings based on patient-reported outcomes suggested significant improvements in patient experience and mental health status, with a 15%-20% decrease in hospitalisation, implying savings of $3000-$4000 per patient annually [85,86].…”