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Table 2 Top 5 questions by topic and PPI rank, compared with non-PPI rank

From: A multi-stakeholder approach to the co-production of the research agenda for medicines optimisation

Patient Concerns

PPI rank

(n = 7)

Non-PPI rank

(n = 25)

 Is there a shared decision (with patients) about using each medicine?

1

2

 How are medication reviews by different healthcare professionals integrated?

2

5

 To what extent are patients’ views and experiences considered during medication reviews?

3a

1

 What are patients’ perspectives and experiences of non-medical prescribers, and does this vary according to different professional groups and different patient groups?

3b

10

 How can communication relevant to medication reviews be enhanced across and within sectors?

5

3

Polypharmacy

PPI rank

Non-PPI rank

 To what extent should polypharmacy involve patients’ views and preferences in shared decision-making?

1

5

 What can patients teach health care professionals about the burden of polypharmacy and coping (or not) mechanisms?

2

11

 Which patients should be targeted by polypharmacy medication reviews, where and when?

3

7

 What are the key components of a good, person-centred, holistic, polypharmacy medication review?

4

6

 If we undertake a polypharmacy medication review well with the right person at the right time, what happens to the patient (i.e. are their outcomes better, does their ‘quality of life’ improve etc.)?

5

2

Non-medical Prescribing

PPI rank

Non-PPI rank

 How can we optimise the contribution of non-medical prescribers to primary care?

1

1

 How can we raise patient awareness of these ‘new’ prescribers?

2

10

 What is the role of the NMP in medicines reviews (e.g. in specialist areas such as rheumatology and type of NMP e.g. pharmacist, nurse)?

3a

6

 How can non-medical prescribers optimise medicines use in vulnerable patient populations e.g. drug misusers, individuals with mental illness?

3b

13

 How is deprescribing, polypharmacy, etc. undertaken by non-medical prescribers?

5

2

Deprescribing

PPI rank

Non-PPI rank

 How can we empower patients to take a more active role in self-management and self-monitoring of multiple long-term conditions, including deprescribing?

1

2

 Should all ‘prescribing’ guidelines include recommendations to deprescribe, and if so how?

2

9

 How can GPs and non-medical prescribers be assisted in dealing with deprescribing of medicines originally prescribed by hospital consultants?

3a

9

 Does providing full access to medical records enable more effective collaborative deprescribing decisions?

3b

8

 How can pharmacological and holistic therapies be merged? E.g. deprescribing of antidepressants.

3c

18