• Henrik Rudolf, Ulrich Thiem, Kaysa Aust, Dietmar Krause, Renate Klaaßen-Mielke, Wolfgang Greiner, Hans J Trampisch, Nina Timmesfeld, Petra Thürmann, Eike Hackmann, Tanja Barkhausen, Ulrike Junius-Walker, and Stefan Wilm.
• Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum; Chair of Geriatrics and Gerontology, University Medical Centre Eppendorf, Hamburg; Centre of Geriatrics and Gerontology, Albertinen-Haus, Hamburg; Institute for General Practice (ifam), Heinrich-Heine University Düsseldorf; Institute for General Practice, Hannover Medical School, Hannover; School of Public Health, University Bielefeld; Philipp Klee-Institute for Clinical Pharmacology, Helios University Hospital Wuppertal, Chair of Clinical Pharmacology, University Witten/Herdecke, Wuppertal; Institute for Biostatistics and Informatics in Medicine and Ageing, Rostock University Medical Center.
• Dtsch Arztebl Int. 2021 Dec 27; 118 (51-52): 875882875-882.

BackgroundMedications with an unfavorable risk-benefit profile in the elderly, and for which there are safer alternatives, are designated as potentially inappropriate medications (PIM). The RIME trial (Reduction of Potentially Inappropriate Medication in the Elderly) was based on PRISCUS, a list of PIM that was developed in 2010 for the German pharmaceuticals market. In this trial, it was studied whether special training and the PRISCUS card could lessen PIM and undesired drug-drug interactions (DDI) among elderly patients in primary care.MethodsA three-armed, cluster-randomized, controlled trial was carried out in two regions of Germany. 137 primary care practices were randomized in equal numbers to one of two intervention groups-in which either the primary care physicians alone or the entire practice team received special training-or to a control group with general instructions about medication. The primary endpoint was the percentage of patients with at least one PIM or DDI (PIM/DDI) per practice. The primary hypothesis was that at 1 year this endpoint would be more effectively lowered in the intervention groups compared to the control group.ResultsAmong 1138 patients regularly taking more than five drugs, 453 (39.8%) had at least one PIM/DDI at the beginning of the trial. The percent - ages of PIM/DDI at the beginning of the trial and 1 year later were 43.0% and 41.3% in the intervention groups and 37.0% and 37.6% in the control group. The estimated intervention effect of any intervention (69 practices) versus control (68 practices) was 2.3% (p = 0.36), while that of team training (35 practices) versus physician training (34 practices) was 4.3% (p = 0.22).ConclusionThe interventions in the RIME trial did not significantly lower the percentage of patients with PIM or DDI.

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