A Structured Process Informed by Data, Evidence and Research – Network (SPIDER-NET) in Optimizing the Care for Patients with Complex Needs and Multiple Medications


Patients over 65 and having ten or more prescriptions represent 8% of all patients followed in primary care. These patients are more at risk of having side effects and drug interactions. The SPIDER model aims to optimize the management of polypharmacy and potentially inappropriate prescriptions for seniors with complex needs followed in primary care.
The objectives are to adapt the SPIDER model and optimize it in a Quebec context, to assess the feasibility of implementing the model and to test the measurement instruments that will be used to evaluate it.
The innovative aspect of the project is the use of available clinical data to support the process of collaborative quality improvement.
Expected outcomes: Four primary care teams from CISSS Laval have implemented the SPIDER approach on polypharmacy in collaboration with INESSS. The teams used the data extracted from their electronic medical record, the most recent tools for deprescribing and were trained to develop action plans adapted to their environment to improve the drug profile of their target patients. This feasibility study made it possible to develop and pre-test the content of the reflexive practice workshops, the tools (in French) intended for patients and health professionals. The COMPAS + polypharmacy workshop may be part of the INESSS service offer. All procedures have been tested and the improved version will be evaluated during the pan-Canadian randomized controlled trial.