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Table 5 Intervention development

From: Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study)

Intervention component

Intervention stage

 

Development

Pilot

Finalised

Academic detailing with a pharmacist

Small, but potentially important, and relatively consistent effects on prescribing [21].

One brief session delivered in pilot, participants instructed on review process and treatment algorithms

One session (30 minutes) discussing:

1) PIP

2) Medicines review

3) Web-based therapeutic treatment algorithms

Medicines review with web-based therapeutic treatment algorithms

Medicines review identified as a strategy to address PIP [10, 28, 29]. Pharmacists have role in providing advice and support to enable GPs conduct medicines reviews [30, 31].

Structure of treatment algorithms revised

One review per patient conducted using web-based platform which guides GP through process

Non-pharmacological alternatives added where applicable

Each treatment algorithm has the following structure:

Barriers of patient preference and time highlighted

1) The individual PIP with reason for concern:

PIP criteria selected Treatment algorithms to be more structured More focus on non-pharmacological alternatives

Structure of web-based system revised

2) Alternative pharmacological and non-pharmacological treatment options

3) Background information (where relevant)

Patient information leaflets

Need for information to give to patients highlighted

Patient information leaflets developed, not well utilised in pilot

Patient information leaflets:

1) Describe the PIP and the reasons as to why it may be inappropriate

Patient information leaflets may be helpful in improving patient outcomes, older patients appreciate information leaflets in addition to verbal information from their doctor [40].

2) Outline the alternative pharmacological and non-pharmacological therapies GPs may offer.