Applying a multidisciplinary intervention for drug adequacy in an intermediate care hospital (AMIDA-ICH): study protocol of a complex intervention trial

Resumen

IntroductionPerson-centred prescription (PCP) is a medication revision based on patients’ frailty status and diagnostic- and drug-centred criteria. This pragmatic trial aims to implement and evaluate a multidimensional PCP intervention to improve pharmacological treatment adequacy in older adults admitted to an intermediate care hospital (ICH), following a mixed-method approach.DescriptionThe “Applying a Multidisciplinary Intervention for Drug Adequacy-ICH” (AMIDA-ICH) study follows a hybrid design. Five hospital wards will enter the intervention phase following a stepped–wedge randomized clinical trial design. Subjects belonging to the control phase will receive usual care; those belonging to the intervention phase will undergo a multidisciplinary PCP. We will evaluate the intervention’s impact on reducing medications and improving treatment adequacy, patient-reported outcome measures, and health outcomes, such as adverse events, hospital admissions, and mortality. Finally, the qualitative part will involve professionals, patients, and carers with the aim of identifying barriers and enablers to implement the intervention.DiscussionThis study is designed to improve therapeutic adequacy and quality of care in older adults through a PCP approach. It focuses on outcomes like efficacy and safety, while also assessing the real-world applicability of the intervention through implementation outcomes.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT07015112, NCT07015112.