The MPI_AGE European Project: Using Multidimensional Prognostic Indices (MPI) to improve cost-effectiveness of interventions in multimorbid frail older persons. Background, aim and design
Abstract
Purpose: The MPI_AGE project is a multicenter project co-funded by the Executive Agency for Health and Consumers in the frame of Active and Healthy Ageing 2nd-Health Programme 2008-2013. Aim of the project is to implement Multidimensional Prognostic Indices (MPI) that predict survival, based on the Comprehensive Geriatric Assessment, in order to improve the cost-effectiveness of health interventions in frail older individuals with multimorbidity and polypharmacy.
Materials and methods: The project is divided in seven Work Packages (WP). WP1, WP2 and WP3 include the activities of coordination, evaluation and dissemination, respectively.
WP4 is a retrospective analysis of clinical, functional and administrative data carried out in order to develop and validate MPI in community-dwelling older subjects. In WP5, the best cost-effective profile of different therapeutic interventions in older individuals with different MPI-based mortality risk profile will be identified.
WP6 is a multicenter prospective study with a follow-up of 12 months carried out in 11 geriatric clinical centres with the aim of evaluating the usefulness of the MPI in the clinical decision making in patients with different mortality risk. In WP7, a systematic process of recommendations will be carried out through the wide involvement of partners, external experts and stakeholders in meetings and web diffusion.
Conclusions: Mortality risk may influence the effectiveness of specific treatments and interventions in frail older subjects with multimorbidity and polypharmacy. Clinicians and health policy makers need to consider the prognostic information obtained through the MPI to identify those setting-specific profiles of older subjects who may better benefit from interventions.