INTRODUCTION: In ageing societies, the number of older adults with complex chronic conditions (CCCs) is rapidly increasing. Care for older persons with CCCs is challenging, due to interactions between multiple conditions and their treatments. In home care and nursing homes, where most older persons with CCCs receive care, professionals often lack appropriate decision support suitable and sufficient to address the medical and functional complexity of persons with CCCs. This EU-funded project aims to develop decision support systems using high-quality, internationally standardised, routine care data to support better prognostication of health trajectories and treatment impact among older persons with CCCs. METHODS AND ANALYSIS: Real-world data from older persons aged ≥60 years in home care and nursing homes, based on routinely performed comprehensive geriatric assessments using interRAI systems collected in the past 20 years, will be linked with administrative repositories on mortality and care use. These include potentially up to 51 million care recipients from eight countries: Italy, the Netherlands, Finland, Belgium, Canada, USA, Hong Kong and New Zealand. Prognostic algorithms will be developed and validated to better predict various health outcomes. In addition, the modifying impact of pharmacological and non-pharmacological interventions will be examined. A variety of analytical methods will be used, including techniques from the field of artificial intelligence such as machine learning. Based on the results, decision support tools will be developed and pilot tested among health professionals working in home care and nursing homes. ETHICS AND DISSEMINATION: The study was approved by authorised medical ethical committees in each of the participating countries, and will comply with both local and EU legislation. Study findings will be shared with relevant stakeholders, including publications in peer-reviewed journals and presentations at national and international meetings.

Aging Research Center Department of Neurobiology Care Sciences and Society Karolinska Institutet and Stockholm University Stockholm Sweden

Amsterdam Public Health research institute Ageing and later life research program Amsterdam The Netherlands

Amsterdam UMC location Vrije Universiteit Amsterdam Department of Epidemiology and Data Science De Boelelaan 1117 Amsterdam The Netherlands

Amsterdam UMC location Vrije Universiteit Amsterdam Department of General Practice De Boelelaan 1117 Amsterdam The Netherlands

Amsterdam UMC location Vrije Universiteit Amsterdam Department of Medicine for Older People De Boelelaan 1117 Amsterdam The Netherlands

Center for Sociological Research KU Leuven Leuven Belgium

Connell School of Nursing Boston College Chestnut Hill Boston MA USA

Data and Analytics Unit Finnish Institute for Health and Welfare Helsinki Finland

Department of Computer Science Vrije Universiteit Amsterdam Amsterdam the Netherlands

Department of Geriatrics and Gerontology 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Public Health and Welfare Finnish Institute for Health and Welfare Helsinki Finland

Department of Social and Clinical Pharmacy Faculty of Pharmacy Charles University Hradec Králové Czech Republic

European Geriatric Medicine Society Vienna Austria

Fondazione Policlinico Universitario A Gemelli IRCCS Rome Italy

Laboratory for Research on Aging Society Chair of Epidemiology and Preventive Medicine Medical Faculty Jagiellonian University Medical College Kraków Poland

LUCAS Center for Care Research and Consultancy KU Leuven Leuven Belgium

Nordic Healthcare Group Helsinki Finland

School of Public Health Sciences University of Waterloo Waterloo Ontario Canada

Stockholm Gerontology Research Center Stockholm Sweden

The Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife Boston MA USA

Università Cattolica del Sacro Cuore Rome Italy

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Protocol of the pilot study to test and evaluate the iCARE tool: a machine learning-based e-platform tool to make health prognoses and support decision-making for the care of older persons with complex chronic conditions