Safer Prescribing and Care for the Elderly (SPACE): Cluster RCT in New Zealand General Practice

About

This study addresses an important translational gap, testing an intervention (SPACE) designed to prompt medicines review and support safer prescribing in routine practice. SPACE comprises an audit to identify and generate for each GP a list of patients with high-risk prescribing, educational and a one-on-one session for each GP to go through with the pharmacist their list of patients with high-risk prescribing, and a tick-box for GPs to indicate their intended action for each patient (letter to the patient, no action, change medicines).

This cluster randomized controlled trial in general practices in the Auckland and Northland regions of New Zealand is testing the effect of the Safer Prescribing And Care for the Elderly (SPACE) intervention on the rate of high-risk prescribing of non-steroidal anti-inflammatory and antiplatelet medicines, and related adverse drug event hospitalizations.

High-risk prescribing, adverse drug events and avoidable adverse drug event hospitalizations are increasingly common as more people are taking more medicines for multiple long-term conditions. The most effective, cost-effective, and practical approach to safer prescribing in routine practice is not yet known. If SPACE is shown to be effective and cost-effective it could be rolled out nationally and used routinely in practices to improve the safety of prescribing.

Publications

• Trial and error: challenges conducting pragmatic trials in general practice
• Safer Prescribing And Care for the Elderly (SPACE): cluster randomised controlled trial in general practice
• Safer Prescribing And Care for the Elderly (SPACE): a pilot study in general practice
• Process evaluation of the Safer Prescribing And Care for the Elderly (SPACE) cluster randomised controlled trial in New Zealand general practice