[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"inappropriate-prescribing\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:inappropriate-prescribing":28},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,3,0,[8,52,81],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":14,"acronym":15,"eligibilityCriteria":16,"healthyVolunteers":17,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":20,"targetDuration":4,"studyType":23,"phases":24,"briefSummary":26,"conditions":27,"keywords":31,"overallStatus":39,"whyStopped":4,"lastUpdateSubmitDate":40,"lastUpdatePostDateStruct":41,"startDateStruct":44,"completionDateStruct":46,"leadSponsor":48,"locationsCount":51},"100618817","reduction-of-low-value-prescribing-through-audit-and-feedback-100618817",false,"NCT07336550","Reduction of Low-value Prescribing Through Audit and Feedback","AFFAP Trial: The Comparative Evaluation of Audit and Feedback-based De-implementation Strategies to Reduce Low-value Prescribing in Primary Care in Patients Over 65 Years of Age.","AFFAP","PRIMARY CARE CENTERS IN THE BARAKALDO-SESTAO INTEGRATED HEALTHCARE ORGANISATION OF OSAKIDETZA-BASQUE HEALTH SERVICE:\n\nInclusion Criteria:\n\n* collaboration is achieved from at least 51% of the General Practitioners (GP) or at least 4 GPs\n* At least 60 patients aged 65 years or older on at least one of the drugs of interest that may be potentially inappropriately prescribed\n\nExclusion Criteria:\n\n* N\u002FA\n\nPATIENTS ASSIGNED TO THE PARTICIPATING PC CENTERS:\n\nInclusion Criteria:\n\n* Patients over 65 years of age with any of the following unsuitability criteria:\n* PIP of benzodiazepines: patients on benzodiazepines for more than 3 months\n* PIP of proton pump inhibitors: patients on proton pump inhibitors for more than 8 weeks without a diagnosed gastrointestinal disease and with no long-term prescription of gastrotoxic drugs.\n* PIP of opioids: patients on opioids for non-cancer pain for more than 3 months.\n\nExclusion Criteria:\n\n* Patients who, in the opinion of the general practitioner, are not suitable candidates for tapering or discontinuation of the potentially inappropriately prescribed drug\n* Patients residing in care homes\n* Patients receiving palliative care",true,"ALL","65 Years",{"count":21,"type":22},540,"ESTIMATED","INTERVENTIONAL",[25],"NA","The objective is to estimate the effect attributable to a primary care pharmacist-led audit and feedback (AF) strategy compared to the currently used AF strategy as a management tool to evaluate healthcare performance focusing on processes and outcomes, for reducing the rate of patients over 65 years of age with potentially inappropriate prescribing (PIP) of benzodiazepines, proton pump inhibitors and opioids.\n\nA closed-cohort stepped-wedge cluster-randomised trial will be conducted in nine PC centres from Barakaldo-Sestao Integrated Health Organization, Basque Health Service (Osakidetza). All health centre clusters will start under the control condition, and after an initial study period of 4 months in the control phase, one centre per step at 1-month intervals will be randomly assigned to crossover to the intervention, under which they will be exposed to an additional component of AF, namely, primary care pharmacist-led facilitation.\n\nMixed-methods analysis will be performed, gathering quantitative data to assess the results of the implementations at health centre and clinician levels, and qualitative data to assess the feasibility and perceived impact of the de-implementation strategies from the clinicians' perspective, and explore the experience and satisfaction of patients regarding the healthcare received.\n\nThis study will provide useful knowledge on the effect attributable to a more intensive AF strategy (facilitated AF) compared to standard procedures of AF reports, and of the characteristics of AF that are most effective.",[28,29,30],"Inappropriate Prescribing","Implementation Science","Behavioral Sciences",[32,33,34,35,36,37,38],"low-value pharmacological prescription","De-implementation","Stepped-wedge design","Benzodiazepines","Proton pump inhibitors","Opioids","audit and feedback","NOT_YET_RECRUITING","2026-05-11",{"date":42,"type":43},"2026-05-13","ACTUAL",{"date":45,"type":22},"2026-06",{"date":47,"type":22},"2027-12",{"name":49,"class":50},"Basque Health Service","OTHER_GOV",1,{"id":53,"slug":54,"hasResults":11,"nctId":55,"briefTitle":56,"officialTitle":57,"acronym":58,"eligibilityCriteria":59,"healthyVolunteers":11,"sex":18,"minAge":60,"maxAge":4,"enrollmentInfo":61,"targetDuration":4,"studyType":23,"phases":63,"briefSummary":64,"conditions":65,"keywords":68,"overallStatus":70,"whyStopped":4,"lastUpdateSubmitDate":40,"lastUpdatePostDateStruct":71,"startDateStruct":73,"completionDateStruct":75,"leadSponsor":77,"locationsCount":80},"100526033","deprescribing-inappropriate-proton-pump-inhibitors-100526033","NCT06129474","Deprescribing Inappropriate Proton Pump Inhibitors","DepRescribing inapprOpriate Proton Pump InhibiTors - the DROPIT Trial: a Cluster Randomized Controlled Trial in Primary Care Setting","DROPIT","Inclusion Criteria:\n\n1. Patient of a participating GP.\n2. Age: minimum 18 years old.\n3. Daily PPI intake for minimum 8 weeks.\n4. PPI in one of the following doses:\n\n   * minimum 40mg\u002Fday pantoprazole;\n   * minimum 40mg\u002Fday omeprazole;\n   * more than 30mg\u002Fday lansoprazole;\n   * more than 30mg\u002Fday dexlansoprazole;\n   * more than 20mg\u002Fday esomeprazole;\n   * more than 20mg\u002Fday rabeprazole.\n5. Sufficient knowledge of German language to understand the trial and follow-up according to GP assessment.\n\nExclusion Criteria:\n\n1. Limited life expectancy according to GP judgement (patients with terminal disease and a life expectancy of less than 12 months.\n2. Unable to provide informed consent.\n3. PPI in an appropriate dose (see Appendix Table A1) and with an established indication for long-term PPI, such as:\n\n   * History of bleeding ulcer.\n   * Peptic ulcer due to cause other than NSAID or H. Pylori.\n   * Barrett's oesophagus.\n   * Severe erosive reflux disease (Los Angeles grade C\u002FD).\n   * GERD with symptoms or complications (oesophageal ulcer, peptic stricture).\n   * Other indications (i.e., Zollinger-Ellison-Syndrome, PPI-sensitive eosinophilic esophagitis, chronic pancreatitis with steatorrhea refractory to enzyme replacement therapy, idiopathic pulmonary fibrosis.)\n4. Two or more of the following medications, or one of the following medications and one or more of the mentioned risk factors mentioned below.\n\nMedications (any dose):\n\n* Daily use of non-steroidal anti-inflammatory drug (NSAID) for more than 7 days.\n* Antiplatelet therapy.\n* Additional antiplatelet therapy (e.g., ticagrelor or similar).\n* Anticoagulant(s).\n* Systemic steroid(s) for more than 1 month.\n\nRisk factors:\n\n* History of gastrointestinal ulcer.\n* Age of 75 years and older.\n* Selective serotonin reuptake inhibitor (SSRI) or serotonin and norepinephrine reuptake inhibitor (SNRI) use.\n* Severe concomitant disease with increased risk of GI bleeding according to the GP's assessment (e.g., severe liver disease, neoplasia, nicotine or alcohol abuse).","18 Years",{"count":62,"type":22},400,[25],"The DROPIT Trial is an interventional, open-labelled, cluster-randomized controlled trial conducted in the Swiss primary care setting. It aims to evaluate an intervention to guide the deprescribing of inappropriate proton-pump inhibitors (PPIs). Therefore, the trial investigates whether the study intervention leads to the deprescribing of inappropriate PPI prescription while ensuring noninferiority safety, in comparison to usual care. Additionally, the trail aims to investigate the intervention's impact on other clinical aspects, as well as addressing features of the implementation of the intervention and its cost-effectiveness.",[28,66,67],"Reflux Disease","Proton Pump Inhibitors",[69,36],"Deprescribing","RECRUITING",{"date":72,"type":43},"2026-05-14",{"date":74,"type":43},"2024-10-01",{"date":76,"type":22},"2027-12-31",{"name":78,"class":79},"University of Bern","OTHER",2,{"id":82,"slug":83,"hasResults":11,"nctId":84,"briefTitle":85,"officialTitle":86,"acronym":4,"eligibilityCriteria":87,"healthyVolunteers":11,"sex":18,"minAge":19,"maxAge":4,"enrollmentInfo":88,"targetDuration":4,"studyType":23,"phases":90,"briefSummary":91,"conditions":92,"keywords":4,"overallStatus":39,"whyStopped":4,"lastUpdateSubmitDate":93,"lastUpdatePostDateStruct":94,"startDateStruct":96,"completionDateStruct":98,"leadSponsor":100,"locationsCount":51},"100624265","ensuring-clinical-appropriateness-and-safety-of-pharmacological-therapies-in-nursing-home-residents-100624265","NCT07407387","Ensuring Clinical Appropriateness and Safety of Pharmacological Therapies in Nursing Home Residents","Appropriateness of Medication Prescribing in Nursing Homes: A Pre-Post Study to Evaluate the Effectiveness of a Clinical Pharmacology Team-Led, Digitally Supported, Inter-Professional Collaboration","Inclusion Criteria:\n\n* Expected to remain in the nursing home for the duration of the study\n* Able to provide informed consent or having a legally authorized representative able to provide consent if the resident lacks capacity\n\nExclusion Criteria:\n\n* Residents in their probable last hours or days of life\n* Residents with moderate to severe cognitive impairment (Cognitive Performance Scale, CPS, score \\>4\n* Residents housed in assisted nursing home wards, including those requiring palliative care (either in dedicated palliative units or receiving palliative care in general wards), those in the hemodialysis unit, and those with severe obesity (body mass index \\>=40kg\u002Fm2)",{"count":89,"type":22},219,[25],"The goal of this clinical study is to evaluate whether a structured, clinical pharmacology team-led medication review improves the appropriateness and safety of medication prescribing in elderly nursing home (NH) residents. The study will also assess the impact of the intervention on indicators of inappropriate prescribing and resident-centred clinical outcomes. The main questions the study aims to answer are: 1) Does a structured, digitally supported, medication review led by clinical pharmacologists reduce inappropriate medication prescribing, as measured by the Medication Appropriateness Index (MAI), in elderly NH residents? 2) Does the intervention reduce indicators of inappropriate prescribing, including potentially inappropriate prescriptions, therapeutic duplicates, drug-drug interactions and anticholinergic burden? 3) Does the intervention improve resident-centred clinical outcomes, such as falls, fractures, delirium, hyper-sedation, emergency department visits and hospitalizations? This is a single-arm, non-randomized, pre-post study conducted in seven NHs in Southern Switzerland. Each resident will serve as their own control, with outcomes compared between a 3-month pre-intervention period and a 3-month post-intervention period.\n\nThe intervention consists of: 1) An individualized, digitally supported, medication review conducted by the team of clinical pharmacologists; 2) Face-to-face feedback to NH healthcare professionals responsible for managing residents' medications; 3) Tailored educational sessions addressing common prescribing issues identified during the medication review.\n\nParticipants will: be aged 65 years or older and reside in participating NHs; have their routinely collected clinical and medication data assessed during a 3-month pre-intervention period; receive the intervention integrated into routine care, with any medication changes implemented by treating clinicians.\n\nThe study is low-risk, non-invasive, and embedded in routine NH care. The results will provide evidence on the clinical effectiveness of integrating clinical pharmacology expertise into inter-professional medication management in Swiss NHs.",[28],"2026-02-24",{"date":95,"type":43},"2026-02-27",{"date":97,"type":22},"2026-03-01",{"date":99,"type":22},"2026-12",{"name":101,"class":79},"Lugano Istituti Sociali"]