# Effectiveness of person-centred versus usual care in elderly patients: findings from a multicentre randomised controlled trial

## TL;DR

A study found that person-centred care improved medication management in elderly patients compared to usual care.

## Contribution

This study provides empirical evidence on the effectiveness of person-centred care in optimizing medication use in polymedicated older adults.

## Key findings

- Patients in the intervention group reduced their number of medications by 1.8 per patient on average.
- The intervention group showed a significant reduction in drug-related prescriptions compared to usual care.
- Changes to pharmacotherapy plans were more persistent at 12 months in the intervention group.

## Abstract

The person-centred care model involves a multidisciplinary team providing individualised health and social care aligned with patient preferences and health goals. Although some evidence supports its use in primary care, it remains under-evaluated. This study aimed to evaluate the effectiveness of a Collaborative Medication Management (CMM) approach in optimising pharmacotherapy plans versus usual care among polymedicated older adults.

A randomised, open-label, multicentre, parallel clinical trial was conducted across 11 Primary Care Teams in Spain (Sept 2020–Jan 2024), including patients aged ≥75 years taking ≥8 chronic medications with complex or advanced conditions. The intervention group (IG, n = 102) received CMM delivered by a multidisciplinary team, including structured medication review, development of a patient-centred care plan, and follow-up at 6 and 12 months. The control group (CG, n = 106) received usual care. Primary outcomes were number of medications, drug-related prescriptions (DRP), changes to pharmacotherapy plans, and hospital admissions. Secondary outcomes included persistence of changes at 12 months and medication-related safety incidents.

A total of 208 subjects were included (65.4% women; mean age 83.6 ± 6.3 years). IG showed a mean reduction of 1.8 ± 2.1 medications/patient vs. an increase of 0.3 ± 1.4 in CG (p = 0.004); a mean reduction of 2.9 ± 2.5 DRP/patient in IG vs. An increase of 0.2 ± 1.2 in CG (p = 0.004); a mean of 4.3 ± 2.9 changes to pharmacotherapy plans in IG vs. 2.6 ± 3.3 in CG (p = 0.004); a mean of 0.3 ± 0.7 hospital admissions in IG vs. 0.3 ± 0.8 in CG (p = 1.000). Persistence of changes at 12 months was 3.8 ± 2.7 in IG vs. 2.2 ± 2.9 in CG (p < 0.001). In addition, a mean of 0.5 ± 0.7 safety incidents was reported in IG vs. 0.5 ± 1.0 in CG (p = 0.676).

The person-centred care model proved effect in optimising medication use in polymedicated older adults.

Trial registration:
ClinicalTrials.gov identifier: NCT04188470.