Evidence map›Paper›PMID 38500163›Full record

ArticleBMC health services research2024

A mixed methods analysis of the medication review intervention centered around the use of the 'Systematic Tool to Reduce Inappropriate Prescribing' Assistant (STRIPA) in Swiss primary care practices.

Katharina Tabea Jungo, Michael J Deml, Fabian Schalbetter, Jeanne Moor, Martin Feller, Renata Vidonscky Lüthold, Corlina Johanna Alida Huibers, Bastiaan Theodoor Gerard Marie Sallevelt, Michiel C Meulendijk, Marco Spruit and 3 more

Erratum issued Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03724539 (Optimizing PharmacoTherapy In the Multimorbid Elderly in Primary CAre), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03724539 nacompletednot on this map

Optimizing PharmacoTherapy In the Multimorbid Elderly in Primary CAre: a Cluster Randomized Controlled Trial (the OPTICA Trial)

TypeinterventionalSponsorUniversity of BernRan2019 to 2021Enrolled323ConditionsMultimorbidity, PolypharmacyArmsSTRIPA intervention, Sham intervention
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 2 countries.

Katharina Tabea JungoInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland. katharina.jungo@protonmail.com.
Michael J DemlInstitute of Sociological Research, University of Geneva, Geneva, Switzerland.
Fabian SchalbetterInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Jeanne MoorInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Martin FellerInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Renata Vidonscky LütholdInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Corlina Johanna Alida HuibersGeriatrics, Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Bastiaan Theodoor Gerard Marie SalleveltDepartment of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, Utrecht, The Netherlands.
Michiel C MeulendijkPublic Health and Primary Care (PHEG), Leiden University Medical Center, Leiden University, Leiden, Netherlands.
Marco SpruitPublic Health and Primary Care (PHEG), Leiden University Medical Center, Leiden University, Leiden, Netherlands.
Matthias SchwenkglenksHealth Economics Facility, Department of Public Health, University of Basel, Basel, Switzerland.
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Sven StreitInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
University of Bern · CHLeiden University · NLLeiden University Medical Center · NLUniversity Hospital of Bern · CHUniversity Medical Center Utrecht · NLUniversity of Geneva · CHUniversity of Zurich · CHUtrecht University · NL

Funding

U.S. Deprescribing Research NetworkR24AG064025 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI BOYD, CYNTHIA MELINDA, STEINMAN, MICHAEL A. · 2019 to 2023
$9.9M
NIA NIH HHS R24 AG064025
6 · The paper itself

Abstract

backgroundElectronic clinical decision support systems (eCDSS), such as the 'Systematic Tool to Reduce Inappropriate Prescribing' Assistant (STRIPA), have become promising tools for assisting general practitioners (GPs) with conducting medication reviews in older adults. Little is known about how GPs perceive eCDSS-assisted recommendations for pharmacotherapy optimization. The aim of this study was to explore the implementation of a medication review intervention centered around STRIPA in the 'Optimising PharmacoTherapy In the multimorbid elderly in primary CAre' (OPTICA) trial.

methodsWe used an explanatory mixed methods design combining quantitative and qualitative data. First, quantitative data about the acceptance and implementation of eCDSS-generated recommendations from GPs (n = 21) and their patients (n = 160) in the OPTICA intervention group were collected. Then, semi-structured qualitative interviews were conducted with GPs from the OPTICA intervention group (n = 8), and interview data were analyzed through thematic analysis.

resultsIn quantitative findings, GPs reported averages of 13 min spent per patient preparing the eCDSS, 10 min performing medication reviews, and 5 min discussing prescribing recommendations with patients. On average, out of the mean generated 3.7 recommendations (SD=1.8). One recommendation to stop or start a medication was reported to be implemented per patient in the intervention group (SD=1.2). Overall, GPs found the STRIPA useful and acceptable. They particularly appreciated its ability to generate recommendations based on large amounts of patient information. During qualitative interviews, GPs reported the main reasons for limited implementation of STRIPA were related to problems with data sourcing (e.g., incomplete data imports), preparation of the eCDSS (e.g., time expenditure for updating and adapting information), its functionality (e.g., technical problems downloading PDF recommendation reports), and appropriateness of recommendations.

conclusionsQualitative findings help explain the relatively low implementation of recommendations demonstrated by quantitative findings, but also show GPs' overall acceptance of STRIPA. Our results provide crucial insights for adapting STRIPA to make it more suitable for regular use in future primary care settings (e.g., necessity to improve data imports).

trial registrationClinicaltrials.gov NCT03724539, date of first registration: 29/10/2018.

Indexed as

General PractitionersInappropriate PrescribingAgedHumansMedication ReviewPolypharmacyPrimary Health CareSwitzerlandElectronic clinical decision support systemMedication optimizationMixed methods researchMultimorbidityPolypharmacyPrimary care

Identifiers

PMID38500163
PMCPMC10949561
OpenAlexW4392905764

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.