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OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly

Objective

Most older adults have multiple chronic diseases (multimorbidity) and multiple medications (polypharmacy).
However, multimorbid patients are often excluded from clinical trials and most guidelines address diseases in
isolation. Inappropriate drug prescription and poor drug compliance are common and contribute to up to 30% of
hospital admissions. OPERAM investigators developed STOPP/START criteria to detect inappropriate drug use,
both over- and underuse. Applying these criteria limits unnecessary polypharmacy and reduces underuse of indicated
medications, but it remains uncertain whether systematic pharmacotherapy optimisation can improve clinical
outcomes and reduce costs.We propose a multicentre randomised controlled trial to assess the impact of a userfriendly
software-assisted intervention to optimise pharmacotherapy and to enhance compliance in 1900 multimorbid
patients aged ≥75 years. Outcomes will include drug-related hospital admissions, health care utilisation, quality of life,
patient preferences and cost-effectiveness. We will also perform several network meta-analyses (NMA) to provide
new comparative evidence on the most effective and safest pharmacological and non-pharmacological interventions
to reduce common causes of preventable hospital admissions (e.g. falls, fractures, bleeding). Therapy optimisation in
the multimorbid elderly, enhanced compliance and discontinuation of less effective interventions have the potential
to improve clinical, quality of life and safety outcomes, while reducing costs. We will provide a structured method
with practical software solutions for optimal prescribing and new comparative evidence from NMAs for addressing
multimorbidity and polypharmacy by means of customised, patient-centred guidelines. OPERAM ultimately aims
at better healthcare delivery in primary and hospital care, based on effective, safe, personalised and cost-effective
interventions that can be applied to the rapidly growing older population in Europe.

Call for proposal

H2020-PHC-2014-two-stage
See other projects for this call

Coordinator

UNIVERSITAET BERN
Address
Hochschulstrasse 6
3012 Bern
Switzerland
Activity type
Higher or Secondary Education Establishments
EU contribution
€ 71 245,56

Participants (8)

UNIVERSITE CATHOLIQUE DE LOUVAIN
Belgium
EU contribution
€ 1 084 375
Address
Place De L Universite 1
1348 Louvain La Neuve
Activity type
Higher or Secondary Education Establishments
UNIVERSITEIT UTRECHT
Netherlands
EU contribution
€ 247 460
Address
Heidelberglaan 8
3584 CS Utrecht
Activity type
Higher or Secondary Education Establishments
UNIVERSITY COLLEGE CORK - NATIONAL UNIVERSITY OF IRELAND, CORK
Ireland
EU contribution
€ 878 006
Address
Western Road
T12 YN60 Cork
Activity type
Higher or Secondary Education Establishments
UNIVERSITAT BASEL
Switzerland
EU contribution
€ 0
Address
Petersplatz 1
4051 Basel
Activity type
Higher or Secondary Education Establishments
TP21 GMBH
Germany
EU contribution
€ 269 000
Address
Luisenstrasse 14
10117 Berlin
Activity type
Private for-profit entities (excluding Higher or Secondary Education Establishments)
PANEPISTIMIO IOANNINON
Greece
EU contribution
€ 185 857,50
Address
Panepistemioypole Panepistemio Ioanninon
45110 Ioannina
Activity type
Higher or Secondary Education Establishments
UNIVERSITAIR MEDISCH CENTRUM UTRECHT
Netherlands
EU contribution
€ 950 398,51
Address
Heidelberglaan 100
3584 CX Utrecht
Activity type
Higher or Secondary Education Establishments
UNIVERSITA DEGLI STUDI GABRIELE D'ANNUNZIO DI CHIETI-PESCARA
Italy
EU contribution
€ 49 265,68
Address
Via Dei Vestini 31
66013 Chieti
Activity type
Higher or Secondary Education Establishments