Brigham and Women's Hospital
The objective of this study is to test a multidisciplinary care team behavioral intervention to enhance medication adherence among older adults with multiple chronic conditions (MCC). The Personalized Routine and Habit Integration to Support Medication Management (PRISM) intervention is a novel, scalable intervention delivered by pharmacists and occupational therapists (OTs) that aims to improve medication adherence by reducing regimen complexity and solidifying medication habits within daily routines. The goal of this randomized control trial is to evaluate the effectiveness and implementation of PRISM compared with enhanced usual care.
Inclusion Criteria: 1. appointment in the past 18 months in the Galter-18 primary care practice 2. ≥2 cardiovascular and/or metabolic chronic conditions documented in the EHR, 3. ≥5 daily medications 4. poor medication adherence ≥1 cardiovascular and/or metabolic medication using validated EHR-data algorithms 5. English-speaking 6. ≥65 years old Exclusion Criteria: 1. severe mental illness 2. dementia 3. dependent on others for medication management 4. have received a pharmacist-led comprehensive medication review in the last 6 months
The PRISM arm will receive three sessions: 1) comprehensive medication management session with a clinical pharmacist, 2) an in-home visit with an occupational therapist (OT), and then 3) follow up phone call with OT.
The EUC arm will receive a comprehensive medication management session with a clinical pharmacist.
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