Development of the Tool to Reduce Inappropriate Medications (TRIM): A Clinical Decision Support System to Improve Medication Prescribing for Older Adults.

Study Objective: To create a clinical decision support system (CDSS) for evaluating problems with medications among older outpatients based on a broad set of criteria.

Design: Web-based CDSS development.

Setting: Primary care clinics at a Veterans Affairs medical center.

A Delphi process to address medication appropriateness for older persons with multiple chronic conditions.

Background: Frameworks exist to evaluate the appropriateness of medication regimens for older patients with multiple medical conditions (MCCs). Less is known about how to translate the concepts of the frameworks into specific strategies to identify and remediate inappropriate regimens.

Methods: Modified Delphi method involving iterative rounds of input from panel members.

The effects of comorbidity on the benefits and harms of treatment for chronic disease: a systematic review.

Background: There are concerns about the potential for unintentional harms when clinical practice guidelines are applied to patients with multimorbidity. The objective was to summarize the evidence regarding the effect(s) of comorbidity on the outcomes of medication for an index chronic condition.

Methods: A systematic review was conducted of studies published in MEDLINE and Cochrane Trials before May 2012.