22 Optimising medication with electronic decision-making assistants in patients with multiple chronical illnesses


Patients suffering from multiple chronic illnesses are often over-medicated or take medications with inappropriate indication. This study aims to establish whether electronic decision-making assistants designed for general practitioners (GPs) can improve prescription appropriateness and quality of life.

Portrait / project description (ongoing research project)

40 GPs will be divided between an intervention group and a control group. The intervention group will be supported by the electronic decision-making assistant while the control group will continue usual care. GPs will decide in agreement with their patient whether or not to accept suggestions to modify treatment. After one year, the appropriateness of the medication prescribed, use of healthcare services (e.g. hospitalisation, visits to the emergency department), frequency of falls, quality of life and costs will be compared among the two groups. Furthermore, the factors for and against introducing this tool into GP practice will be studied.


Most older people suffer from multiple chronical illnesses, they also take many different medications. GPs often have insufficient time to systematically examine their patients’ list of medication. However, excessive and inappropriate medication and errors when taking prescribed treatments increase health risks and costs. Electronic decision-making assistants can help GPs to review medication and limit undesirable effects.


A study will be carried out to test the effectiveness of electronic decision-making assistants. In addition, a qualitative study will analyse how the tool is integrated into GP practice.

Relevance / Application

The decision-making assistant should help to optimise medication for patients suffering from multiple chronic illnesses, improve their quality of life and reduce costs. If it proves effective, the tool could be used by all GP practices.

Original title

Optimising pharmacotherapy In the multimorbid elderly in primary care: a cluster randomised controlled trial (the OPTICA trial)

Project leaders


  • Dr. Sven Streit, Berner Institut für Hausarztmedizin (BIHAM), Universität Bern


  • Prof. Dr. med. Nicolas Rodondi, Berner Institut für Hausarztmedizin, Universität Bern
  • Prof. Matthias Schwenkglenks, Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich

Project partners:

  • Dr. Marco Spruit, Department of Information and Computing Sciences, Utrecht University
  • Dr. Sven Trelle, Clinical Trials Unit (CTU) Bern, Departement Klinische Forschung, Universität Bern
  • Dr. Gerhard Schilling, Institut für Praxisinformatik (IPI)



Further information on this content


Prof. Dr. med. Dr. phil Sven Streit Leiter Grundversorgung Medizin
Berner Institut für Hausarztmedizin (BIHAM)
Universität Bern
Gesellschaftsstrasse 49 3012 Bern +41 31 631 58 75

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