A pilot study of the OptiMEDs intervention: A complex intervention for multidisciplinary review (including nurses, pharmacists, and physicians) in nursing homes, with ICT-support for the evaluation of the appropriateness of prescribing and for side-effect

The interest in improving the pharmacotherapy of older adults in nursing homes is growing. We propose a method intending to support the decision of GPs regarding the pharmacotherapy of older adults. To achieve this, we introduce the OptiMEDs intervention: a combination of an electronic decision support tool (for the appraisal of potentially inappropriate medication use, anticholinergic use, or medications that can be de-prescribed in view of limited life expectancy) with focussed nurse observations (guided by a list of potential medication symptoms based on the individual medication chart of the resident), that will serve as the basis for a multidisciplinary medication review with the input of the GP, community pharmacist and nurse. By using the OptiMEDs intervention, we expect to obtain a more appropriate, safer, and more cost-effective pharmacotherapy in nursing home residents (e.g. less medication-related symptoms, less potentially inappropriate prescribing, a better quality of life, less hospitalisations, health care usage, or mortality)

Before investigating the effectiveness of the OptiMEDs intervention in a large pragmatic clinical trial comparing results of the intervention with standard of care, we will performing a pilot study in 3 nursing homes aiming to study the feasibility and acceptability of all components included in OptiMEDs.