IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0298181.html
   My bibliography  Save this article

Effectiveness and cost-effectiveness of a collaborative deprescribing intervention of proton-pump-inhibitors on community-dwelling older adults: Protocol for the C-SENIoR, a pragmatic non-randomized controlled trial

Author

Listed:
  • Sónia Romano
  • Luis Monteiro
  • José Pedro Guerreiro
  • João Braga Simões
  • António Teixeira Rodrigues
  • Nuno Lunet
  • Julian Perelman

Abstract

Introduction: Worldwide, demographic ageing is a major social, economic and health challenge. Despite the increase in life expectancy, elderly often live with multiple chronic conditions, exposing them to multiple medications. Concerns have been raised about the growing issue of inappropriate long-term usage of proton-pump inhibitors (PPI), which have been associated with adverse outcomes and increased healthcare costs. Deprescribing is a recommended intervention to reduce or withdraw medicines that might be causing harm or might no longer be of benefit. This protocol details a trial to assess the effectiveness and cost-effectiveness of a collaborative deprescribing intervention of PPI among community-dwelling elderly, involving community pharmacists and general practitioners. Methods and analysis: A pragmatic, multicentre, two-arm, non-randomised controlled trial of a structured PPI collaborative deprescribing intervention in the primary care setting with a 6-month follow-up will be conducted. Patients must be 65 years old or older, live in the community and have been using PPI for more than 8 weeks. We hypothesize that the intervention will reduce the PPI usage in the intervention group compared to the control group. The primary outcome is the successful discontinuation or dose decrease of any PPI, defined as a statistically significant absolute 20% reduction in medication use between the intervention and control groups at 3- and 6-month follow-ups. An economic evaluation will be conducted alongside the trial. This study was approved by the Ethics Research Committee of Nova Medical School, NOVA University of Lisbon and by the Ethics Committee from the Local Health Unit Alto Minho, Portugal. Discussion: This pragmatic trial will provide evidence on the effectiveness and cost-effectiveness of a patient-centred collaborative deprescribing intervention in the community setting in Portugal. It will also inform improvements for the development of future multi-faceted interventions that aim to optimise medication for the community-dwelling elderly. Clinical trial registration: ISRCTN 49637686.

Suggested Citation

  • Sónia Romano & Luis Monteiro & José Pedro Guerreiro & João Braga Simões & António Teixeira Rodrigues & Nuno Lunet & Julian Perelman, 2024. "Effectiveness and cost-effectiveness of a collaborative deprescribing intervention of proton-pump-inhibitors on community-dwelling older adults: Protocol for the C-SENIoR, a pragmatic non-randomized c," PLOS ONE, Public Library of Science, vol. 19(3), pages 1-15, March.
    • Handle: RePEc:plo:pone00:0298181
    DOI: 10.1371/journal.pone.0298181
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0298181
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0298181&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0298181?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453, Decembrie.
    2. Elisabeth Fenwick & Karl Claxton & Mark Sculpher, 2001. "Representing uncertainty: the role of cost‐effectiveness acceptability curves," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 779-787, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Nonpharmacological Interventions for Dementia Patients and their Caregivers - A Systematic Literature Review," Working Papers 2018:10, Lund University, Department of Economics.
    2. Mohsen Sadatsafavi; & Carlo Marra; & Lawrence McCandless & Stirling Bryan, 2012. "The challenge of incorporating external evidence in trial-based cost-effectiveness analyses: the use of resampling methods," Health, Econometrics and Data Group (HEDG) Working Papers 12/24, HEDG, c/o Department of Economics, University of York.
    3. Aidan R. Vining & David L. Weimer, 2013. "An assessment of important issues concerning the application of benefit–cost analysis to social policy," Chapters, in: Scott O. Farrow & Richard Zerbe, Jr. (ed.), Principles and Standards for Benefit–Cost Analysis, chapter 1, pages 25-62, Edward Elgar Publishing.
    4. Andrija S Grustam & Nasuh Buyukkaramikli & Ron Koymans & Hubertus J M Vrijhoef & Johan L Severens, 2019. "Value of information analysis in telehealth for chronic heart failure management," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-23, June.
    5. Nicholas Graves & Mary Courtney & Helen Edwards & Anne Chang & Anthony Parker & Kathleen Finlayson, 2009. "Cost-Effectiveness of an Intervention to Reduce Emergency Re-Admissions to Hospital among Older Patients," PLOS ONE, Public Library of Science, vol. 4(10), pages 1-9, October.
    6. Hoch, Jeffrey S. & Blume, Jeffrey D., 2008. "Measuring and illustrating statistical evidence in a cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 27(2), pages 476-495, March.
    7. Kobelt, G., 2013. "Health Economics: An Introduction to Economic Evaluation," Monographs, Office of Health Economics, number 000004.
    8. Casey Quinn, 2005. "Generalisable regression methods for costeffectiveness using copulas," Health, Econometrics and Data Group (HEDG) Working Papers 05/13, HEDG, c/o Department of Economics, University of York.
    9. Nadja Chernyak & Heribert Sattel & Marsel Scheer & Christina Baechle & Johannes Kruse & Peter Henningsen & Andrea Icks, 2014. "Economic Evaluation of Brief Psychodynamic Interpersonal Therapy in Patients with Multisomatoform Disorder," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-4, January.
    10. Douwe Postmus & Tommi Tervonen & Gert Valkenhoef & Hans Hillege & Erik Buskens, 2014. "A multi-criteria decision analysis perspective on the health economic evaluation of medical interventions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(7), pages 709-716, September.
    11. Sennen Hounton & David Newlands, 2012. "Applying the Net-Benefit Framework for Analyzing and Presenting Cost-Effectiveness Analysis of a Maternal and Newborn Health Intervention," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-8, July.
    12. Paal Joranger & Arild Nesbakken & Halfdan Sorbye & Geir Hoff & Arne Oshaug & Eline Aas, 2020. "Survival and costs of colorectal cancer treatment and effects of changing treatment strategies: a model approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 321-334, April.
    13. Saha, Sanjib & Gerdtham, Ulf-G. & Toresson, Håkan & Minthon, Lennart & Jarl, Johan, 2018. "Economic Evaluation of Interventions for Screening of Dementia," Working Papers 2018:20, Lund University, Department of Economics.
    14. Mark Oppe & Daniela Ortín-Sulbarán & Carlos Vila Silván & Anabel Estévez-Carrillo & Juan M. Ramos-Goñi, 2021. "Cost-effectiveness of adding Sativex® spray to spasticity care in Belgium: using bootstrapping instead of Monte Carlo simulation for probabilistic sensitivity analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 711-721, July.
    15. Laurence M. Djatche & Stefan Varga & Robert D. Lieberthal, 2018. "Cost-Effectiveness of Aspirin Adherence for Secondary Prevention of Cardiovascular Events," PharmacoEconomics - Open, Springer, vol. 2(4), pages 371-380, December.
    16. Ties Hoomans & Johan Severens & Nicole Roer & Gepke Delwel, 2012. "Methodological Quality of Economic Evaluations of New Pharmaceuticals in the Netherlands," PharmacoEconomics, Springer, vol. 30(3), pages 219-227, March.
    17. Khan, Mohammed Tajuddin & Kishore, Avinash & Joshi, Pramod K., 2016. "Gender dimensions on farmers’ preferences for direct-seeded rice with drum seeder in India," IFPRI discussion papers 1550, International Food Policy Research Institute (IFPRI).
    18. Daphne C. Voormolen & Judith A. M. Bom & Esther W. Bekker-Grob & Werner B. F. Brouwer & Job Exel, 2024. "Development and Content Validation of the 10-item Well-being Instrument (WiX) for use in Economic Evaluation Studies," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 19(2), pages 381-413, April.
    19. Noémi Kreif & Richard Grieve & M. Zia Sadique, 2013. "Statistical Methods For Cost‐Effectiveness Analyses That Use Observational Data: A Critical Appraisal Tool And Review Of Current Practice," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 486-500, April.
    20. Barbara Graaff & Lei Si & Amanda L. Neil & Kwang Chien Yee & Kristy Sanderson & Lyle C. Gurrin & Andrew J. Palmer, 2017. "Population Screening for Hereditary Haemochromatosis in Australia: Construction and Validation of a State-Transition Cost-Effectiveness Model," PharmacoEconomics - Open, Springer, vol. 1(1), pages 37-51, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0298181. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.