Evidence mapPaperPMID 37213749Full record

ArticlePEC innovation2022

Development of a shared decision-making intervention to improve drug safety and to reduce polypharmacy in frail elderly patients living at home.

E Drewelow, M Ritzke, A Altiner, A Icks, J Montalbo, V Kalitzkus, S Löscher, Y Pashutina, S Fleischer, J Abraham and 9 more

Open access · goldAbstract read
In one paragraph

Article in PEC innovation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.3field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 5 institutions in 1 country.

E DrewelowInstitute of General Practice, University Medical Center Rostock, Doberaner Straße 142, 18057 Rostock, Germany.
M RitzkeInstitute of General Practice, University Medical Center Rostock, Doberaner Straße 142, 18057 Rostock, Germany.
A AltinerInstitute of General Practice, University Medical Center Rostock, Doberaner Straße 142, 18057 Rostock, Germany.
A IcksInstitute for Health Services and Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
J MontalboInstitute for Health Services and Economics, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
V KalitzkusInstitute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
S LöscherInstitute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
Y PashutinaInstitute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
S FleischerInstitute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle, Germany.
J AbrahamInstitute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112 Halle, Germany.
P ThürmannDepartment of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany.
N K MannDepartment of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Heusnerstraße 40, 42283 Wuppertal, Germany.
B WieseWG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
S WilmInstitute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
A WollnyInstitute of General Practice, University Medical Center Rostock, Doberaner Straße 142, 18057 Rostock, Germany.
G FeldmeierInstitute of General Practice, University Medical Center Rostock, Doberaner Straße 142, 18057 Rostock, Germany.
T BuuckInstitute of General Practice, University Medical Center Rostock, Doberaner Straße 142, 18057 Rostock, Germany.
A MortsieferInstitute of General Practice and Primary Care, Faculty of Health, Department of Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany.
COFRAIL study group
Heinrich Heine University Düsseldorf · DEUniversity of Rostock · DEWitten/Herdecke University · DEMartin Luther University Halle-Wittenberg · DEMedizinische Hochschule Hannover · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: For patients with geriatric frailty, reducing inappropriate medication is an important goal to improve patient safety in primary care. GP-side barriers include knowledge gaps, legal concerns, and lack of communication between the actors involved. The aim was to develop a multi-faceted intervention to facilitate deprescribing and shared prioritisation among frail elderlies with polypharmacy living at home. Methods: Mixed methods study including: 1) scoping review on family conferences, expert panels; 2) group discussions with GPs, mapping of needs and challenges in Primary Care; 3) workshops and expert interviews with GPs, patient advocates, researchers as a basis for a theoretical intervention model; 4) piloting. Results: A major challenge for GPs is to conduct a productive discussion with patients and family cares on deprescribing and drug safety. A guideline for a structured family conference with a medication check and geriatric assessment was developed and proved to be feasible in the pilot study. Conclusion: The intervention developed to facilitate deprescribing and shared prioritisation of drug therapy based on family conferences seems suitable to be tested in a subsequent cRCT. Innovation: Adapting family conferences to primary care for frail patients with polypharmacy.

Indexed as

DeprescribingFamily ConferenceFrailtyPolypharmacyPrimary Care

Identifiers

PMID37213749
PMCPMC10194292
OpenAlexW4220912608

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.