A Swiss Interprofessional Network for Reviewing Inappropriate Medication in Primary Care

NCT ID: NCT07283055

Last Updated: 2026-01-08

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 250 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-01-01
• Study Completion Date: 2027-06-30

Brief Summary

The aim of the SINERGIC pilot study is to assess the feasibility in the Swiss context of implementing interprofessional medication reviews between GP and pharmacists, as part of a shared decision-making process with patients. The acceptability and potential effectiveness of such an intervention will also be assessed.

This assessment will enable the investigators to take into account the determining factors for setting up a large-scale study to support the sustainable financing of this service in the long term.

Detailed Description

The ageing population is leading to an increase in the prevalence of chronic conditions among older adults, often resulting in excessive polypharmacy. Polypharmacy, as well as the prescription of high-risk medications in this population, exposes them to more adverse effects, which can lead to falls and hospitalisation. This problem is of concern to healthcare professionals, whether they be general practitioners (GP), who have an overview of medical records, or dispensing pharmacists, who have an overview of medication. In Switzerland, these two professions still operate often in isolation from each other, but genuine collaboration is essential if we are to improve and manage polypharmacy among the elderly and limit the risks. Medication reviews are recognised as promising strategies for improving the quality of prescribing in patients with multiple medications.

This pilot trial does not randomly select participants and does not include a control group. It is a hybrid study that aims both to test the effectiveness of the intervention and to prepare for its implementation.

The study plans to include at least 250 patients from three groups of general practices in different settings. Participants will be aged 65 or older, take at least five chronic medications, and suffer from at least three chronic conditions. Individuals living in medical institutions will not be included.

Intervention:

• Step 1 (optional): Patients taking at least 10 chronic medications and experiencing adherence or side effect issues may benefit from a specialised consultation with a pharmacist.
• Step 2: The pharmacist identifies any medication-related issues for each patient and discusses them directly with the general practitioner in order to agree on the necessary adjustments.
• Step 3: During a medical appointment, the doctor and patient will decide together whether to implement the proposed changes.
• Step 4: The pharmacist will follow up after a few days and then again after 3 months.

Main objective: To assess whether this service is feasible in the context of the study.

Secondary objectives: Measure whether the intervention is well accepted (questionnaires and interviews) by the patients and healthcare professionals involved.

Exploratory objectives: Study the impact of the intervention on the quality of drug treatments, patients' quality of life and drug costs.

Conditions

Medication Review; Primary Care

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

Patient with medication review

Group Type: OTHER

Medication review

Intervention Type: OTHER

• Step 1 (optional): Patients taking at least 10 chronic medications and experiencing adherence or side effect issues may benefit from a specialised consultation with a pharmacist.
• Step 2: The pharmacist identifies any medication-related issues for each patient and discusses them directly with the general practitioner in order to agree on the necessary adjustments.
• Step 3: During a medical appointment, the doctor and patient will decide together whether to implement the proposed changes.
• Step 4: The pharmacist will follow up after a few days and then again after 3 months.

Interventions

Medication review

• Step 1 (optional): Patients taking at least 10 chronic medications and experiencing adherence or side effect issues may benefit from a specialised consultation with a pharmacist.
• Step 2: The pharmacist identifies any medication-related issues for each patient and discusses them directly with the general practitioner in order to agree on the necessary adjustments.
• Step 3: During a medical appointment, the doctor and patient will decide together whether to implement the proposed changes.
• Step 4: The pharmacist will follow up after a few days and then again after 3 months.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age ≥ 65 years old;
• Regular use of at least 5 medications (chronic treatments, > 3 months);
• Patients with a minimum of 3 chronic diseases;
• Regular follow-up in a GP practice taking part in the project;
• Adequate understanding of French.
• Written informed consent

Exclusion Criteria

• Residence in an institution (residential care facility, nursing home, etc.) ;
• Cognitive impairment preventing understanding or obtaining informed consent;
• Any other clinical situation deemed incompatible with participation, as decided by the GP in charge.

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Bern

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Camille Lanfranchi, MSc

Role: STUDY_CHAIR

University of Bern (BIHAM)

Juliane Fringeli, MSc

Role: STUDY_CHAIR

University of Bern (BIHAM)

Locations

Institute of Primary Health Care (BIHAM)

Bern, , Switzerland

Countries

Switzerland

Central Contacts

Alice Panchaud, Prof

Role: CONTACT

alice.panchaudmonnat@unibe.ch

+41 31 684 58 89

Facility Contacts

Camille Lanfranchi

Role: primary

camille.lanfranchi@unibe.ch

Juliane Fringeli

Role: backup

juliane.fringeli@unibe.ch

References

Mallet L, Spinewine A, Huang A. The challenge of managing drug interactions in elderly people. Lancet. 2007 Jul 14;370(9582):185-191. doi: 10.1016/S0140-6736(07)61092-7.

Reference Type: BACKGROUND

PMID: 17630042 (View on PubMed)

Liew TM, Lee CS, Goh SKL, Chang ZY. The prevalence and impact of potentially inappropriate prescribing among older persons in primary care settings: multilevel meta-analysis. Age Ageing. 2020 Jul 1;49(4):570-579. doi: 10.1093/ageing/afaa057.

Reference Type: BACKGROUND

PMID: 32365168 (View on PubMed)

Cole JA, Goncalves-Bradley DC, Alqahtani M, Barry HE, Cadogan C, Rankin A, Patterson SM, Kerse N, Cardwell CR, Ryan C, Hughes C. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2023 Oct 11;10(10):CD008165. doi: 10.1002/14651858.CD008165.pub5.

Reference Type: BACKGROUND

PMID: 37818791 (View on PubMed)

Other Identifiers

SINERGIC_01

Identifier Type: -

Identifier Source: org_study_id