Managing Appropriate Prescribing in COPD

Objective: Reducing inappropriate medications for primary care COPD patients with comorbidities (\'medication-comorbidity clashes\'), by evaluation of the Desktop Helper (number 10) in a pragmatic cluster randomized controlled trial. Study design: A four-arm pragmatic cluster randomized controlled trial (cluster RCT), which will be conducted in GP practices in the Netherlands. In the cluster RCT, the control condition (arm 1: care as usual) will be compared with three intervention arms (i.e. arm 2: the \'Desktop Helper (number 10)\' , arm 3: an e-learning module, and arm 4: the \'Desktop Helper (number 10)\' accompanied by the e-learning module). At baseline and at 26 weeks of follow-up, a data-extraction of comorbidities and prescribed medications will be obtained from the EMR of participating GP practices. Study population: Primary care patients with COPD who have 1 or more comorbidities and who are prescribed one or more medications. Intervention (if applicable): Clinical rules to remediate \'medication-comorbidity clashes\' as outlined in the \'Desktop Helper (number 10)\'. These clinical rules will be implemented in the EMR to enable the identification of patients with \'medication-comorbidity clashes\'. In addition, e-learning about these \'medication-comorbidity clashes\' will be offered depending on the treatment arm of the trial. Main study parameters/endpoints: The number of \'medication-comorbidity clashes\'.