Evidence mapPaperPMID 42418407Full record

Trial reportPloS one2026

Complex intervention programme to improve patient safety and facilitate deprescribing in frail older patients living at home (COFRAIL): A process evaluation of a cluster randomised controlled trial.

Jens Abraham, Steffen Fleischer, Achim Mortsiefer, Eva Drewelow, Manuela Ritzke, Birgitt Wiese, Charalabos Markos Dintsios, Veronika Bencheva, Petra Thürmann, Stefan Wilm and 2 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Jens AbrahamInstitute of Health, Midwifery and Nursing Science, Medical Faculty of Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.ORCID https://orcid.org/0000-0001-6985-1530
Steffen FleischerInstitute of Health, Midwifery and Nursing Science, Medical Faculty of Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Achim MortsieferFaculty of Health, Department of Medicine, Institute of General Practice and Primary Care, Witten/Herdecke University, Witten, Germany.
Eva DrewelowClinic for Forensic Psychiatry, University Medical Centre Rostock, Rostock, Germany.
Manuela RitzkeInstitute of General Practice, University Medical Centre Rostock, Rostock, Germany.
Birgitt WieseWG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
Charalabos Markos DintsiosFaculty of Medicine, Institute for Health Services Research and Health Economics, Centre for Health and Society, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.ORCID https://orcid.org/0000-0003-3469-092X
Veronika BenchevaFaculty of Health, Center for Clinical Trials, Witten/Herdecke University, Witten, Germany.ORCID https://orcid.org/0009-0006-8594-0537
Petra ThürmannChair of Clinical Pharmacology, Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany.
Stefan WilmInstitute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Gabriele MeyerInstitute of Health, Midwifery and Nursing Science, Medical Faculty of Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
COFRAIL study group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFrailty is associated with negative health outcomes in geriatric patients. A large proportion of frail patients is affected by polypharmacy, which in turn may be a possible cause of frailty. The cluster randomised controlled COFRAIL trial investigated the effects of family conferences to improve the care of frail patients. Deprescribing and communication about prioritising health goals between patients, relatives and general practitioners were key components of the intervention. An accompanying process evaluation was conducted to investigate whether the study intervention was implemented as intended and to describe the experiences of the target groups.

methodsThe process evaluation took place between February 2019 and October 2021 and followed international guidelines. Process parameters were collected using study documentation, standardised questionnaires and guided telephone interviews with a convenience sample of patients, relatives and general practitioners. Quantitative data were analysed descriptively, qualitative data through content analysis.

resultsAlmost all general practitioners in the intervention group completed both mandatory trainings. Overall, 68% of the patients took part in all three planned family conferences, 85% in at least two. Patients, relatives and general practitioners reported positive experiences with the family conferences. Patients and relatives felt involved in the decision-making process and had predominantly no concerns when medication was discontinued. Only a few general practitioners considered the implementation of family conferences in regular care to be impractical. A supportive pharmacological hotline was not utilised frequently by the general practitioners. Due to the SARS-CoV-2 pandemic, some study procedures were adapted but did not have any negative impact.

conclusionsWhile the COFRAIL study did not achieve its primary goals, we identified no major barriers in the implementation of the intervention programme. Overall, the target groups experienced the approach of family conferences positively. However, the process evaluation provides valuable lessons for designing and implementing similar interventions in the future.

Indexed as

DeprescriptionsFrail ElderlyPatient SafetyAgedAged, 80 and overFemaleGeneral PractitionersHumansMalePolypharmacySurveys and Questionnaires

Identifiers

PMID42418407
PMCPMC13345250

What Socratic holds

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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.