INTRODUCTION: The provision of optimal care for older adults with complex chronic conditions (CCCs) poses significant challenges due to the interplay of multiple medical, pharmacological, functional and psychosocial factors. To address these challenges, the I-CARE4OLD project, funded by the EU-Horizon 2020 programme, developed an advanced clinical decision support tool-the iCARE tool-leveraging large longitudinal data from millions of home care and nursing home recipients across eight countries. The tool uses machine learning techniques applied to data from interRAI assessments, enriched with registry data, to predict health trajectories and evaluate pharmacological and non-pharmacological interventions. This study aims to pilot the iCARE tool and assess its feasibility, usability and impact on clinical decision-making among healthcare professionals. METHODS AND ANALYSIS: A minimum of 20 participants from each of the seven countries (Italy, Belgium, the Netherlands, Poland, Finland, Czechia and the USA) participated in the study. Participants were general practitioners, geriatricians and other medical specialists, nurses, physiotherapists and other healthcare providers involved in the care of older adults with CCC. The study design involved pre-surveys and post-surveys, tool testing with hypothetical patient cases and evaluations of predictions and treatment recommendations. Two pilot modalities-decision loop and non-decision loop-were implemented to assess the effect of the iCARE tool on clinical decisions. Descriptive statistics and bivariate and multivariate analysis will be conducted. All notes and text field data will be translated into English, and a thematic analysis will be performed. The pilot testing started in September 2024, and data collection ended in January 2025. At the time this protocol was submitted for publication, data collection was complete but data analysis had not yet begun. ETHICS AND DISSEMINATION: Ethical approvals were granted in each participating country before the start of the pilot. All participants gave informed consent to participate in the study. The results of the study will be published in peer-reviewed journals and disseminated during national and international scientific and professional conferences and meetings. Stakeholders will also be informed via the project website and social media, and through targeted methods such as webinars, factsheets and (feedback) workshops. The I-CARE4OLD consortium will strive to publish as much as possible open access, including analytical scripts. Databases will not become publicly available, but the data sets used and/or analysed as part of the project can be made available on reasonable request and with the permission of the I-CARE4OLD consortium.

Aging and Later Life Research Program Amsterdam Public Health Research Institute Amsterdam the Netherlands

Center for Sociological Research CeSO KU Leuven Leuven Flanders Belgium

Connell School of Nursing Boston College Boston Massachusetts USA

Department of General Practice Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam the Netherlands

Department of Geriatrics and Gerontology 1st Faculty of Medicine Charles University Prague Prague 2 Czech Republic

Department of Oral Health Sciences KU Leuven Leuven Flanders Belgium

Department of Social and Clinical Pharmacy Faculty of Pharmacy Charles University Hradec Králové 57 Czech Republic

Fondazione Policlinico Universitario Agostino Gemelli IRCCS Roma Lazio 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 Flanders Belgium

Nordic Healthcare Group Helsinki Finland

Profility Inc Checker Software Solutions Haifa Israel

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

Università Cattolica del Sacro Cuore Milan Lombardy Italy

University Hospital Department of Internal Medicine and Geriatrics Jagiellonian University Kraków Poland

University of Helsinki Faculty of Medicine Helsinki Finland

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