Active not recruitingNAINTERVENTIONAL

SPIDER: A Research & QI Collaboration Supporting Practices in Improving Care for Complex Elderly Patients

The SPIDER study wants to help older people who take many different medications, a common situation known as 'polypharmacy'. Sometimes, these medicines might not be needed or could cause harm. Organisations like Choosing Wisely Canada have highlighted certain medicines that might be overused in older adults, such as those for stomach acid, anxiety, agitation, and some diabetes treatments. SPIDER is a program designed to help family doctors, nurses, and pharmacists work together to review and improve medicine use for their older patients. It uses information from patient records and provides coaching to help practices find better ways to manage prescriptions. The study will check if this approach reduces potentially unsuitable medicines and improves patient well-being, while also looking at costs and how satisfied patients and staff are.

At a glance

Status

Active not recruiting

Phase

Sponsor

University of Toronto Practice Based Research Network

Enrolment target

104

Start

26 Mar 2018

Estimated completion

31 Mar 2027

Polypharmacy Inappropriate Prescribing Aged Primary Health Care Quality Improvement Electronic Health Records

What is this study about?

Many older people find themselves taking several different medicines for various health conditions. This is known as 'polypharmacy'. While medicines are vital for treating illnesses, sometimes taking too many can lead to problems. Some drugs might interact with each other, cause unwanted side effects, or simply no longer be necessary, potentially making people feel unwell, less active, or even increasing their risk of falls.

Organisations have identified certain types of medicines that might be prescribed more often than needed for older adults. These include some medications for stomach acid, anxiety, sleep, agitation, and certain types for diabetes that carry a higher risk of low blood sugar. The SPIDER study aims to help healthcare teams – like your family doctor, nurses, and pharmacists – review these medicines with you in a structured way. They'll use information from your health records and work with a coach to find better ways to manage your prescriptions.

The goal is to make sure you're only taking the medicines you truly need, which could improve your overall health and quality of life. The study will also look at how patients feel about this approach, how satisfied healthcare providers are, and the costs involved. It's about making sure your care is as safe and effective as possible.

Key takeaways

The SPIDER study aims to help older patients who take many medicines.
It focuses on reviewing and potentially reducing medicines that might not be needed or could be harmful.
Your family doctor's team will work with support to improve your medication plan.
The goal is to improve your health, reduce side effects, and enhance your quality of life.
Participation means your usual care will be enhanced with a structured medicine review approach.

Who may be eligible?

To join this study, your family doctor's practice must already share electronic health record information with certain research networks in Canada, and your doctor needs to agree to participate and lead a team at their practice.

For you to be considered, you must be 65 years old or older and have seen your doctor at least once in the past two years. You also need to have been prescribed ten or more different medications in the last year, according to your electronic health records.

You wouldn't be able to join if your doctor doesn't meet the practice requirements, or if you are under 65, haven't seen your doctor in the last two years, or are currently taking fewer than ten different prescribed medications. The study focuses specifically on older adults who take many medicines.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 65 years old or older?
Have you visited your family doctor’s practice in the last two years?
Do you currently take ten or more different prescribed medications?
Does your family doctor's practice use electronic health records that contribute to research networks?

Answer every question to see your result.

What does participation involve?

If your doctor's practice is selected for this study, your involvement would primarily be through your usual appointments. The study aims to improve the way your doctor's team reviews and manages your medications as part of your routine care. This means your doctor, nurse, or pharmacist might spend more time discussing your current medications with you and looking for ways to simplify your prescriptions if appropriate.

You won't be asked to visit extra clinics specifically for the study. The changes will happen within your regular care setting. There might be questionnaires to understand your experiences and satisfaction with any changes made to your medication plan. The total duration of your participation would depend on how long your doctor's practice is involved in the study program, but it's integrated into your ongoing healthcare.

Potential risks and benefits

There are potential benefits to taking part, such as having your medications carefully reviewed, which could lead to fewer side effects, improved health, and a better quality of life if some medicines are reduced or adjusted. There are no major new risks associated with this study, as it aims to improve your existing care. Any changes to your medication will be made by your healthcare team in discussion with you. You always have the right to discuss concerns with your doctor and can choose not to continue with any specific changes proposed as part of this improvement process.

Locations (9)

Southern Alberta Primary Care Research Network (SAPCReN)
Verified postcode
Calgary, Canada
Northern Alberta Primary Care Research Network (NAPCReN)
Verified postcode
Edmonton, Canada
British Columbia node of the pan-Canadian CPCSSN (BC-CPCSSN)
Verified postcode
Vancouver, Canada
Manitoba Primary Care Research Network (MaPCReN)
Verified postcode
Winnipeg, Canada
Atlantic Practice Based Research Network (APBRN)
Verified postcode
St. John's, Canada
Maritime Family Practice Research Network (MaRNet-FP)
Verified postcode
Halifax, Canada
Ottawa Practice Enhancement Network (OPEN )
Verified postcode
Ottawa, Canada
University of Toronto Practice Based Research Network
Verified postcode
Toronto, Canada
Réseau de recherche en soins primaires de l'Université de Montréal (RRSPUM)
Verified postcode
Laval, Canada

Common questions

What is 'polypharmacy'?

It means taking many different medicines, usually ten or more, which is common in older adults with several health conditions.

What kind of medicines are being looked at?

The study focuses on medicines that might be overused in older people, like some for stomach acid, anxiety, sleep, agitation, and certain diabetes treatments.

Will I have to take new medicines?

No, the study's main goal is to review and potentially reduce or simplify your current medicines, not to add new ones.

Who will be reviewing my medicines?

Your usual family doctor, along with their team like nurses and pharmacists, will be involved in looking at your prescriptions.

Is this a new type of treatment?

No, it's an organised way for your healthcare team to improve how they manage your existing medicines, using proven methods and support.