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Displaying Results 1 - 19 of 19 on page 1 of 1
Marked
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‘Potentially inappropriate or specifically appropriate?’ Qualitative evaluation of general practitioners views on prescribing, polypharmacy and potentially inappropriate prescribing in older people.
(2016)
Clyne, Barbara; Cooper, Janine A; Hughes, Carmel M; Fahey, Tom; Smith, Susan M; OPTI-SC...
‘Potentially inappropriate or specifically appropriate?’ Qualitative evaluation of general practitioners views on prescribing, polypharmacy and potentially inappropriate prescribing in older people.
(2016)
Clyne, Barbara; Cooper, Janine A; Hughes, Carmel M; Fahey, Tom; Smith, Susan M; OPTI-SCRIPT Study Team
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p><strong>Background:</strong> Potentially inappropriate prescribing (PIP) is common in older people in primary care, as evidenced by a significant body of quantitative research. However, relatively few qualitative studies have investigated the phenomenon of PIP and its underlying processes from the perspective of general practitioners (GPs). The aim of this paper is to explore qualitatively, GP perspectives regarding prescribing and PIP in older primary care patients.</p> <p><strong>Method:</strong> Semi-structured qualitative interviews were conducted with GPs participating in a randomised controlled trial (RCT) of an intervention to decrease PIP in older patients (≥70 years) in Ireland. Interviews were conducted with GP participants (both intervention and control) from the OPTI-SCRIPT cluster RCT as part of the trial process evaluation between January and J...
https://epubs.rcsi.ie/gpart/97
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A process evaluation of a cluster randomised trial to reduce potentially inappropriate prescribing in older people in primary care (OPTI-SCRIPT study).
(2016)
Clyne, Barbara; Cooper, Janine A; Hughes, Carmel M; Fahey, Tom; Smith, Susan M; OPTI-SC...
A process evaluation of a cluster randomised trial to reduce potentially inappropriate prescribing in older people in primary care (OPTI-SCRIPT study).
(2016)
Clyne, Barbara; Cooper, Janine A; Hughes, Carmel M; Fahey, Tom; Smith, Susan M; OPTI-SCRIPT study team
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p>BACKGROUND: The OPTI-SCRIPT cluster randomised controlled trial (RCT) found that a three-phase multifaceted intervention including academic detailing with a pharmacist, GP-led medicines reviews, supported by web-based pharmaceutical treatment algorithms, and tailored patient information leaflets, was effective in reducing potentially inappropriate prescribing (PIP) in Irish primary care. We report a process evaluation exploring the implementation of the intervention, the experiences of those participating in the study and lessons for future implementation.</p> <p>METHODS: The OPTI-SCRIPT trial included 21 GP practices and 196 patients. The process evaluation used mixed methods. Quantitative data were collected from all GP practices and semi-structured interviews were conducted with GPs from intervention and control groups, and a purposive sample of patients from the intervention gr...
https://epubs.rcsi.ie/gpart/98
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Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study)
(2013)
Clyne, Barbara; Bradley, Marie C; Hughes, Carmel M; Clear, Daniel; McDonnell, Ronan; Wi...
Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study)
(2013)
Clyne, Barbara; Bradley, Marie C; Hughes, Carmel M; Clear, Daniel; McDonnell, Ronan; Williams, David; Fahey, Tom; Smith, Susan M; on behalf of the OPTI-SCRIPT study team
Abstract:
Abstract Background Potentially inappropriate prescribing (PIP) in older people is common in primary care and can result in increased morbidity, adverse drug events, hospitalizations and mortality. The prevalence of PIP in Ireland is estimated at 36% with an associated expenditure of over €45 million in 2007. The aim of this paper is to describe the application of the Medical Research Council (MRC) framework to the development of an intervention to decrease PIP in Irish primary care. Methods The MRC framework for the design and evaluation of complex interventions guided the development of the study intervention. In the development stage, literature was reviewed and combined with information obtained from experts in the field using a consensus based methodology and patient cases to define the main components of the intervention. In the pilot stage, five GPs tested the proposed intervention. Qualitative interviews were co...
http://dx.doi.org/10.1186/1472-6963-13-307
Marked
Mark
Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study).
(2013)
Clyne, Barbara; Bradley, Marie C; Hughes, Carmel M; Clear, Daniel; McDonnell, Ronan; Wi...
Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study).
(2013)
Clyne, Barbara; Bradley, Marie C; Hughes, Carmel M; Clear, Daniel; McDonnell, Ronan; Williams, David; Fahey, Tom; Smith, Susan M; OPTI-SCRIPT study team
Abstract:
<p>The original article is available at <a href="http://www.biomedcentral.com">www.biomedcentral.com</a></p>
<p>BACKGROUND: Potentially inappropriate prescribing (PIP) in older people is common in primary care and can result in increased morbidity, adverse drug events, hospitalizations and mortality. The prevalence of PIP in Ireland is estimated at 36% with an associated expenditure of over €45 million in 2007. The aim of this paper is to describe the application of the Medical Research Council (MRC) framework to the development of an intervention to decrease PIP in Irish primary care.</p> <p>METHODS: The MRC framework for the design and evaluation of complex interventions guided the development of the study intervention. In the development stage, literature was reviewed and combined with information obtained from experts in the field using a consensus based methodology and patient cases to define the main components of the int...
https://epubs.rcsi.ie/gpart/39
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Diagnosing malignant melanoma in ambulatory care: a systematic review of clinical prediction rules.
(2017)
Harrington, Emma; Clyne, Barbara; Wesseling, Nieneke; Sandhu, Harkiran; Armstrong, Laur...
Diagnosing malignant melanoma in ambulatory care: a systematic review of clinical prediction rules.
(2017)
Harrington, Emma; Clyne, Barbara; Wesseling, Nieneke; Sandhu, Harkiran; Armstrong, Laura; Bennett, Holly; Fahey, Tom
Abstract:
<p>The original article is available at <a href="http://bmjopen.bmj.com">http://bmjopen.bmj.com</a></p>
<p>OBJECTIVES: Malignant melanoma has high morbidity and mortality rates. Early diagnosis improves prognosis. Clinical prediction rules (CPRs) can be used to stratify patients with symptoms of suspected malignant melanoma to improve early diagnosis. We conducted a systematic review of CPRs for melanoma diagnosis in ambulatory care.</p> <p>DESIGN: Systematic review.</p> <p>DATA SOURCES: A comprehensive search of PubMed, EMBASE, PROSPERO, CINAHL, the Cochrane Library and SCOPUS was conducted in May 2015, using combinations of keywords and medical subject headings (MeSH) terms.</p> <p>STUDY SELECTION AND DATA EXTRACTION: Studies deriving and validating, validating or assessing the impact of a CPR for predicting melanoma diagnosis in ambulatory care were included. Data extraction and methodological qualit...
https://epubs.rcsi.ie/gpart/112
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Did the Celtic Tiger decrease socio-economic differentials in perinatal mortality in Ireland?
(2010)
Layte, Richard; Clyne, Barbara
Did the Celtic Tiger decrease socio-economic differentials in perinatal mortality in Ireland?
(2010)
Layte, Richard; Clyne, Barbara
Abstract:
Irish perinatal mortality rates have been falling steadily for a number of decades but evidence from the 1980s showed pronounced differentials in mortality rates across socio-economic groups. Between 1995 and 2006 Irish gross national product increased from 60 per cent of the EU average to 110 per cent. Real incomes increased across the income distribution during this period but income inequality between the top and bottom income deciles increased marginally. This paper examines whether socio-economic differentials in Irish perinatal mortality rates changed between the 1980s and 2000s. This task is complicated by demographic change in Ireland since the 1980s and its interaction with the birth registration process. Overall perinatal mortality rates have fallen from 14 per 1,000 in 1984 to 7 per 1,000 in 2006. Without adjusting for demographic change, differentials between professional and unskilled/unemployed groups have decreased from 1.99 to 1.79. Adjusted estimates suggest the rea...
http://hdl.handle.net/2262/58717
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Effectiveness of medicines review with web-based pharmaceutical treatment algorithms in reducing potentially inappropriate prescribing in older people in primary care: a cluster randomised trial (OPTI-SCRIPT study)
(2014)
Clyne, Barbara
Effectiveness of medicines review with web-based pharmaceutical treatment algorithms in reducing potentially inappropriate prescribing in older people in primary care: a cluster randomised trial (OPTI-SCRIPT study)
(2014)
Clyne, Barbara
Abstract:
<p><strong>Background: </strong>Potentially inappropriate prescribing (PIP) is common and can result in increased morbidity, adverse drug events and hospitalisations. In 2007, 36% of Irish people aged 70 years or over received at least one potentially inappropriate prescription, with an associated expenditure of €45 million. This thesis documents the design, conduct, and evaluation of a cluster randomised controlled trial (RCT) in Irish primary care focused on reducing PIP in older patients (> 70 years).</p> <p><strong>Methods: </strong>The intervention development was guided by the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. Literature and information from experts were combined to define the main components of the intervention which was then tested with five GPs during the pilot and evaluated using qualitative interviews</p> <p>During the OPTI-SCRIPT trial 21 practices...
https://epubs.rcsi.ie/phdtheses/127
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Effectiveness of medicines review with web-based pharmaceutical treatment algorithms in reducing potentially inappropriate prescribing in older people in primary care: a cluster randomized trial (OPTI-SCRIPT study protocol).
(2013)
Clyne, Barbara; Bradley, Marie C; Smith, Susan M; Hughes, Carmel M; Motterlini, Nicola;...
Effectiveness of medicines review with web-based pharmaceutical treatment algorithms in reducing potentially inappropriate prescribing in older people in primary care: a cluster randomized trial (OPTI-SCRIPT study protocol).
(2013)
Clyne, Barbara; Bradley, Marie C; Smith, Susan M; Hughes, Carmel M; Motterlini, Nicola; Clear, Daniel; McDonnell, Ronan; Williams, David; Fahey, Tom; study team, OPTI-SCRIPT
Abstract:
<p>This article is also available from <a href="http://www.biomedcentral.com">www.biomedcentral.com</a></p>
<p>BACKGROUND: Potentially inappropriate prescribing in older people is common in primary care and can result in increased morbidity, adverse drug events, hospitalizations and mortality. In Ireland, 36% of those aged 70 years or over received at least one potentially inappropriate medication, with an associated expenditure of over €45 million.The main objective of this study is to determine the effectiveness and acceptability of a complex, multifaceted intervention in reducing the level of potentially inappropriate prescribing in primary care.</p> <p>METHODS/DESIGN: This study is a pragmatic cluster randomized controlled trial, conducted in primary care (OPTI-SCRIPT trial), involving 22 practices (clusters) and 220 patients. Practices will be allocated to intervention or control arms using minimization, with intervention ...
https://epubs.rcsi.ie/gpart/34
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Gone for good? An online survey of emigrant health professionals using Facebook as a recruitment tool
(2016)
McAleese, Sara; Clyne, Barbara; Matthews, Anne; Brugha, Ruairi; Humphries, Niamh
Gone for good? An online survey of emigrant health professionals using Facebook as a recruitment tool
(2016)
McAleese, Sara; Clyne, Barbara; Matthews, Anne; Brugha, Ruairi; Humphries, Niamh
Abstract:
<p>This article is also available at <a href="http://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-0130-y">http://human-resources-health.biomedcentral.com/articles/10.1186/s12960-016-0130-y</a></p>
<h3>Background</h3> <p id="x-Par1">Health professionals, particularly doctors, nurses and midwives, are in high demand worldwide. Therefore, it is important to assess the future plans and likelihood of return of emigrating health professionals. Nevertheless, health professionals are, by definition, a difficult population to track/survey. This exploratory study reports on the migration intentions of a sample of doctors, nurses and midwives who had emigrated from Ireland, a high-income country which has experienced particularly high outward and inward migration of health professionals since the year 2000.</p> <h3>Methods</h3> <p id="x-Par2">Health professionals who h...
https://epubs.rcsi.ie/ephmart/63
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Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review
(2016)
Wallace, Emma; Uijen, Maike J M; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galv...
Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review
(2016)
Wallace, Emma; Uijen, Maike J M; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galvin, Rose; Smith, Susan M.; Fahey, Tom
Abstract:
OBJECTIVES: Following appropriate validation, clinical prediction rules (CPRs) should undergo impact analysis to evaluate their effect on patient care. The aim of this systematic review is to narratively review and critically appraise CPR impact analysis studies relevant to primary care. SETTING: Primary care. PARTICIPANTS: Adults and children. INTERVENTION: Studies that implemented the CPR compared to usual care were included. STUDY DESIGN: Randomised controlled trial (RCT), controlled before-after, and interrupted time series. PRIMARY OUTCOME: Physician behaviour and/or patient outcomes. RESULTS: A total of 18 studies, incorporating 14 unique CPRs, were included. The main study design was RCT (n=13). Overall, 10 studies reported an improvement in primary outcome with CPR implementation. Of 6 musculoskeletal studies, 5 were effective in altering targeted physician behaviour in ordering imaging for patients presenting with ankle, knee and neck musculoskeletal injuries. Of 6 cardiova...
http://hdl.handle.net/10344/4998
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Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review.
(2016)
Wallace, Emma; Uijen, Maike JM; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galvi...
Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review.
(2016)
Wallace, Emma; Uijen, Maike JM; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galvin, Rose; Smith, Susan M; Fahey, Tom
Abstract:
<p>This article is also available at <a href="http://bmjopen.bmj.com/content/6/3/e009957.full.pdf+html">http://bmjopen.bmj.com/content/6/3/e009957.full.pdf+html</a></p>
<p>OBJECTIVES: Following appropriate validation, clinical prediction rules (CPRs) should undergo impact analysis to evaluate their effect on patient care. The aim of this systematic review is to narratively review and critically appraise CPR impact analysis studies relevant to primary care.</p> <p>SETTING: Primary care.</p> <p>PARTICIPANTS: Adults and children.</p> <p>INTERVENTION: Studies that implemented the CPR compared to usual care were included.</p> <p>STUDY DESIGN: Randomised controlled trial (RCT), controlled before-after, and interrupted time series.</p> <p>PRIMARY OUTCOME: Physician behaviour and/or patient outcomes.</p> <p>RESULTS: A total of 18 studies, incorporating 14 unique CPRs, were inc...
https://epubs.rcsi.ie/gpart/93
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Interventions to address potentially inappropriate prescribing in community-dwelling older adults: a systematic review of randomized controlled trials
(2016)
Clyne, Barbara; Fitzgerald, Ciaran; Quinlan, Aisling; Hardy, Colin; Galvin, Rose; Fahey...
Interventions to address potentially inappropriate prescribing in community-dwelling older adults: a systematic review of randomized controlled trials
(2016)
Clyne, Barbara; Fitzgerald, Ciaran; Quinlan, Aisling; Hardy, Colin; Galvin, Rose; Fahey, Tom; Smith, Susan M.
Abstract:
OBJECTIVES: To perform a systematic review to determine the effectiveness of interventions designed to reduce potentially inappropriate prescribing (PIP) in community-dwelling older adults.DESIGN: Systematic review and narrative synthesis.SETTING: Primary and community care.PARTICIPANTS: Community-dwelling older adults.MEASUREMENTS: The primary outcome was change in PIP measured using implicit or explicit tools. Studies were grouped into organizational, professional, financial, regulatory, and multifaceted interventions.RESULTS: Twelve randomized controlled trials were identified with baseline PIP prevalence of 18% to 100%. Four of six organizational interventions reported a reduction in PIP, particularly through pharmacists conducting medication reviews. Evidence of the effectiveness of multi-disciplinary teams was weak. Both of the two professional (targeting prescriber's directly) interventions were computerized clinical decision support interventions and were effective in d...
http://hdl.handle.net/10344/6094
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Interventions to Address Potentially Inappropriate Prescribing in Community-Dwelling Older Adults: A Systematic Review of Randomized Controlled Trials.
(2016)
Clyne, Barbara; Fitzgerald, Ciaran; Quinlan, Aisling; Hardy, Colin; Galvin, Rose; Fahey...
Interventions to Address Potentially Inappropriate Prescribing in Community-Dwelling Older Adults: A Systematic Review of Randomized Controlled Trials.
(2016)
Clyne, Barbara; Fitzgerald, Ciaran; Quinlan, Aisling; Hardy, Colin; Galvin, Rose; Fahey, Tom; Smith, Susan M
Abstract:
<p>This is the peer reviewed version of the following article: Clyne B, Fitzgerald C, Quinlan A, Hardy C, Galvin R, Fahey T, Smith SM. Interventions to Address Potentially Inappropriate Prescribing in Community-Dwelling Older Adults: A Systematic Review of Randomized Controlled Trials. Journal of the American Geriatrics Society. 2016;64(6):1210-22, which has been published in final form at <a>doi: 10.1111/jgs.14133</a>. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.</p>
<p>OBJECTIVES: To perform a systematic review to determine the effectiveness of interventions designed to reduce potentially inappropriate prescribing (PIP) in community-dwelling older adults.</p> <p>DESIGN: Systematic review and narrative synthesis.</p> <p>SETTING: Primary and community care.</p> <p>PARTICIPANTS: Community-dwelling older adults.</p> <p>MEASUREMENTS...
https://epubs.rcsi.ie/gpart/101
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Link workers providing social prescribing and health and social care coordination for people with multimorbidity in socially deprived areas (the LinkMM trial): protocol for a pragmatic randomised controlled trial
(2021)
Kiely, Bridget; Clyne, Barbara; Boland, Fiona; O'Donnell, Patrick; Connolly, Deird...
Link workers providing social prescribing and health and social care coordination for people with multimorbidity in socially deprived areas (the LinkMM trial): protocol for a pragmatic randomised controlled trial
(2021)
Kiely, Bridget; Clyne, Barbara; Boland, Fiona; O'Donnell, Patrick; Connolly, Deirdre; O'Shea, Eamon; Smith, Susan M
Abstract:
Introduction Link workers are non-health or social care professionals based in primary care who support people to develop and achieve a personalised set of health and social goals by engaging with community resources. Link workers have been piloted in areas of deprivation, but there remains insufficient evidence to support their effectiveness. Multimorbidity is increasing in prevalence, but there are limited evidence-based interventions. This paper presents the protocol for a randomised controlled trial (RCT) that will test the effectiveness of link workers based in general practices in deprived areas in improving health outcomes for people with multimorbidity.
http://hdl.handle.net/10344/9772
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Reducing potentially inappropriate prescribing for older people in primary care: cost-effectiveness of the opti-script intervention
(2018)
Gillespie, Paddy; Clyne, Barbara; Raymakers, Adam; Fahey, Tom; Hughes, Carmel M.; Smith...
Reducing potentially inappropriate prescribing for older people in primary care: cost-effectiveness of the opti-script intervention
(2018)
Gillespie, Paddy; Clyne, Barbara; Raymakers, Adam; Fahey, Tom; Hughes, Carmel M.; Smith, Susan M.
Abstract:
Objectives: This study examines the cost-effectiveness of the OPTI-SCRIPT intervention on potentially inappropriate prescribing in primary care. Methods: Economic evaluation, using incremental cost-effectiveness and cost utility analyses, conducted alongside a cluster randomized controlled trial of twenty-one general practices and 196 patients, to compare a multifaceted intervention with usual practice in primary care in Ireland. Potentially inappropriate prescriptions (PIPs) were determined by a pharmacist. Incremental costs, PIPs, and quality-adjusted life-years (QALYs) at 12-month follow-up were estimated using multilevel regression. Uncertainty was explored using cost-effectiveness acceptability curves. Results: The intervention was associated with a nonsignificant mean cost increase of Euro407 (95 percent CIs, -357-1170), a significant mean reduction in PIPs of 0.379 (95 percent CI, 0.092-0.666), and a nonsignificant mean increase in QALYs of 0.013 (95 percent CIs, -0.016-0.042...
http://hdl.handle.net/10379/11644
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Supporting prescribing in Irish primary care: protocol for a non-randomised pilot study of a general practice pharmacist (GPP) intervention to optimise prescribing in primary care.
(2018)
Cardwell, Karen; Clyne, Barbara; Moriarty, Frank; Wallace, Emma; Fahey, Tom; Boland, Fi...
Supporting prescribing in Irish primary care: protocol for a non-randomised pilot study of a general practice pharmacist (GPP) intervention to optimise prescribing in primary care.
(2018)
Cardwell, Karen; Clyne, Barbara; Moriarty, Frank; Wallace, Emma; Fahey, Tom; Boland, Fiona; McCullagh, L; Clarke, S; Finnigan, K; Daly, M; Barry, M; Smith, S M; General Practice Pharmacist (GPP) Study Group
Abstract:
<p>The original article is available at <a href="https://www.biomedcentral.com">www.biomedcentral.com</a></p>
<p><strong>Background:</strong> Prescribing for patients taking multiple medicines (i.e. polypharmacy) is challenging for general practitioners (GPs). Limited evidence suggests that the integration of pharmacists into the general practice team could improve the management of these patients. The aim of this study is to develop and test an intervention involving pharmacists, working within GP practices, to optimise prescribing in Ireland, which has a mixed public and private primary healthcare system.</p> <p><strong>Methods:</strong> This non-randomised pilot study will use a mixed-methods approach. Four general practices will be purposively sampled and recruited. A pharmacist will join the practice team for 6 months. They will participate in the management of repeat prescribing and undertake medic...
https://epubs.rcsi.ie/gpart/124
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Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (sppire): a cluster randomised controlled trial protocol and pilot
(2018)
McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Mori...
Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (sppire): a cluster randomised controlled trial protocol and pilot
(2018)
McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Moriarty, Frank; Fahey, Tom; Hughes, Carmel; Gillespie, Paddy; Smith, Susan M.
Abstract:
Background: Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care. Methods: This study is a cluster randomised controlled trial, involving 30 general practices and 450 patients throughout Ireland. Practices will be eligible to participate if they have at least 300 patients aged 65 years and over on their patient panel and if th...
http://hdl.handle.net/10379/12718
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Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE): a cluster randomised controlled trial protocol and pilot.
(2017)
McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Mori...
Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE): a cluster randomised controlled trial protocol and pilot.
(2017)
McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Moriarty, Frank; Fahey, Tom; Hughes, Carmel; Gillespie, Paddy; Smith, Susan M
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p><strong>Background:</strong> Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care.</p> <p><strong>Methods:</strong> This study is a cluster randomised controlled trial, involving 30 general practices a...
https://epubs.rcsi.ie/gpart/114
Marked
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Sustained effectiveness of a multifaceted intervention to reduce potentially inappropriate prescribing in older patients in primary care (OPTI-SCRIPT study).
(2016)
Clyne, Barbara; Smith, Susan M; Hughes, Carmel M; Boland, Fiona; Cooper, Janine A; Fahe...
Sustained effectiveness of a multifaceted intervention to reduce potentially inappropriate prescribing in older patients in primary care (OPTI-SCRIPT study).
(2016)
Clyne, Barbara; Smith, Susan M; Hughes, Carmel M; Boland, Fiona; Cooper, Janine A; Fahey, Tom; OPTI-SCRIPT study team
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p>BACKGROUND: Potentially inappropriate prescribing (PIP) is common in older people in primary care and can result in increased morbidity, adverse drug events and hospitalisations. We previously demonstrated the success of a multifaceted intervention in decreasing PIP in primary care in a cluster randomised controlled trial (RCT).</p> <p>OBJECTIVE: We sought to determine whether the improvement in PIP in the short term was sustained at 1-year follow-up.</p> <p>METHODS: A cluster RCT was conducted with 21 GP practices and 196 patients (aged ≥70) with PIP in Irish primary care. Intervention participants received a complex multifaceted intervention incorporating academic detailing, medicine review with web-based pharmaceutical treatment algorithms that provide recommended alternative treatment options, and tailored patient information leaflets. Control practices delivered us...
https://epubs.rcsi.ie/gpart/94
Displaying Results 1 - 19 of 19 on page 1 of 1
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