NCT02942927: TAPER-RCT

Team Approach to Polypharmacy Evaluation and Reduction

Completed NA Last updated 12 January 2026

What this trial tests

NA trial testing Medication reduction in Multi-morbidity in 345 participants. Completed in 31 July 2025.

Timeline

4 June 2018

Primary endpoint
31 July 2025

31 July 2025

Quick facts

Lead sponsor	McMaster University
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	double
Primary purpose	prevention
Enrollment	345
Start date	4 June 2018
Primary completion	31 July 2025
Estimated completion	31 July 2025
Sites	1 location across Canada

Drugs / interventions tested

• Medication reduction

Conditions studied

• Multi-morbidity — all drugs for Multi-morbidity →
• Medication Therapy Management — all drugs for Medication Therapy Management →
• Polypharmacy — all drugs for Polypharmacy →

Sponsor

McMaster University

Who can join

70 and older, any sex, with Multi-morbidity or Medication Therapy Management. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

In an aging population, most seniors suffer from multiple chronic conditions. When the number of medications taken is ≥5 (polypharmacy), the burden of taking multiple concurrent medications can do more harm than good. Seniors take an average of 7 regular medications and studies link polypharmacy with adverse effects on morbidity, function and health service use. However, it is not clear to what extent these are reversible if medication burden is reduced.

This trial will test the effects on medication numbers and patient health outcomes of an intervention to polypharmacy. This study will test a program focused on medication reduction number and dose. Prioritizing medications according to the patient's preference as reducing the dose also reduces the risk of drug side effects.

Patients, aged 70 years of age or older and are taking ≥5 medications, will randomly receive the program immediately or at 6 months. The program involves information gathering from the patient, including systematically seeking patients priorities and preferences medication review with the pharmacist and then a consultation with the family doctor. The intervention is focused on discontinuing/reducing the dose of medications where possible using a 'pause and monitor' framework to assess the need for restart. An electronic program that detects drug adverse effects and flags potentially inappropriate medications will be integrated into an electronic clinical pathway incorporating monitoring and follow up systems.

This study will examine effects on patient and health relevant outcome measures as well as qualitative research exploring patients' and clinicians' experiences of reducing medication burden. The results will be used to determine whether this system can be implemented as part of routine preventative care in primary care for older adults.

Publications & conference data

6 peer-reviewed publications reference this trial (live from Europe PMC):

1. Interventions to improve the appropriate use of polypharmacy for older people.
   Rankin A, Cadogan CA, Patterson SM, Kerse N, et al · · 2018 · cited 265× · PMID 30175841 · DOI 10.1002/14651858.cd008165.pub4
2. Interventions to improve the appropriate use of polypharmacy for older people.
   Cole JA, Gonçalves-Bradley DC, Alqahtani M, Barry HE, et al · · 2023 · cited 50× · PMID 37818791 · DOI 10.1002/14651858.cd008165.pub5
3. Medication review in hospitalised patients to reduce morbidity and mortality.
   Bülow C, Clausen SS, Lundh A, Christensen M. · · 2023 · cited 37× · PMID 36688482 · DOI 10.1002/14651858.cd008986.pub4
4. Team approach to polypharmacy evaluation and reduction: study protocol for a randomized controlled trial.
   Mangin D, Lamarche L, Agarwal G, Banh HL, et al · · 2021 · cited 14× · PMID 34702336 · DOI 10.1186/s13063-021-05685-9
5. Theoretical Underpinnings of a Model to Reduce Polypharmacy and Its Negative Health Effects: Introducing the Team Approach to Polypharmacy Evaluation and Reduction (TAPER).
   Mangin D, Lamarche L, Templeton JA, Salerno J, et al · · 2023 · cited 11× · PMID 37603255 · DOI 10.1007/s40266-023-01055-z
6. Team approach to polypharmacy evaluation and reduction: feasibility randomized trial of a structured clinical pathway to reduce polypharmacy.
   Mangin D, Lamarche L, Agarwal G, Ali A, et al · · 2023 · cited 11× · PMID 37202822 · DOI 10.1186/s40814-023-01315-0