Medicine

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Level 1
Trinity Biomedical Sciences Institute
Trinity College
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Dublin 2

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PI: Prof. Susan Smith, Institute of Population Health, Trinity College Dublin (susmith@tcd.ie)

Collaborators:

  • University of Galway, Department of General Practice
  • RCSI University of Health Sciences Dublin, Department of General Practice
  • Irish College of General Practice (ICGP)
  • HRB Primary Care Clinical Trials Network Ireland (https://primarycaretrials.ie/midas-2/)

Funding: Health Research Board (HRB) Definitive Interventions and Feasibility Awards (DIFA-2023-002)

Objective: This trial evaluates the clinical and cost-effectiveness of two multimorbidity interventions designed to support people with multiple long-term conditions to manage their medicines and access community resources. The study aims to determine if structured medication reviews and social prescribing embedded within primary care improve health outcomes, experience of care, and well-being compared to standard care.

Key Components:

  1. MyComrade (Pharmacist-Led Medication Review): A pharmacist works collaboratively with patients and GPs to review medications, optimize regimens, reduce potentially inappropriate prescribing, and minimize medication burden through tailored action plans.
  2. LinkMM (Link Worker-Led Social Prescribing): A link worker based in general practice meets with patients to review their health and social priorities and connects them with community resources and services to address identified needs.
  3. Control Arm: Usual GP care with no additional support for medication reviews or social prescribing.

Study Design: Multi-arm (definitive) cluster-randomized trial across 48 diverse general practices in Ireland. Practices are randomly allocated to one of three arms (16 practices per arm) stratified by practice size and location (urban, rural, mixed).

Participants: Adults aged 18+ years enrolled in Ireland's Chronic Disease Management (CDM) Programme with 2 or more chronic conditions and taking at least 10 regular medicines.

Timeline: April 2023 to January 2027 (6-month intervention period per participant)

Primary Outcomes:

  • MyComrade arm: Number of medicines per patient (measured via medical records)
  • LinkMM arm: Patient capability and well-being (measured using ICECAP-A questionnaire)

Secondary Outcomes: Quality of life (EQ-5D-5L), mental health (SWEMWBS), treatment burden, patient experience (PACIC), patient activation (PAM), healthcare utilization, potentially inappropriate prescribing, and cost-effectiveness data.

Innovation:

  • Addresses dual challenges of medication burden and social/health needs in people with multiple chronic conditions through integrated approaches.
  • Implements link worker social prescribing and structured pharmacist medication reviews within routine primary care settings.

Impact:

  • Will provide evidence to inform policy and funding decisions about embedding pharmacists and link workers in Irish general practice.
  • Potential to reduce medication burden and improve health outcomes for people with multimorbidity.
  • Contributes to a more holistic, person-centered approach to managing complex conditions in primary care.
  • Findings may inform implementation of similar interventions in other healthcare systems.

Keywords: Multimorbidity, medication review, social prescribing, primary care, general practice, cluster randomized trial, Ireland, health outcomes, cost-effectiveness

 

Timeline: December 2025-December 2028

Aim: DIVE aims to significantly improve dementia care by enhancing knowledge, empathy, and communication skills among DIVE Champions (frontline healthcare staff, new care companions, and public service providers); developing innovative, multilingual VR training; rigorously piloting and validating immersive scenarios; and sustainably embedding these tools into routine practice, reducing stigma and fostering dementia-inclusive communities.

This study is a partnership with RESURSE (non-profit organisation in Romania), DA-RE Health Innovation, AIT (Austrian Institute of Technology) and the Hospital del Mar Research Institute, Barcelona. Trinity Researchers on this project: Prof. Brian Lawlor, and GBHI Fellows Dr. Raluca Sfetcu, Bouke David De Jong and Dr. Olga Castaner. The project is funded by an ERASMUS+ KA220-ADU grant.

PI: Katy Tobin is the Trinity PI for this partner project.