Evidence map›Paper›PMID 41991224›Full record

Observational studyThe British journal of general practice : the journal of the Royal College of General Practitioners2026

Impact of structured medication reviews on prescribing in English primary care: a retrospective observational cohort study.

James P Sheppard, Paul A Bateman, Cynthia Wright-Drakesmith, Christopher Elles Clark, Rebecca K Barnes, Andrew Paul Clegg, Gary A Ford, Seema Gadhia, William Hinton, Fd Richard Hobbs and 16 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The British journal of general practice : the journal of the Royal College of General Practitioners, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Structured medication reviews: prescribing change is not the same as medicines optimisation.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  2. Exploring the implementation and integration of structured medication reviews in primary care: a qualitative evaluation using normalisation process theory.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

James P SheppardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK james.sheppard@phc.ox.ac.uk.ORCID 0000-0002-4461-8756
Paul A BatemanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-0626-7809
Cynthia Wright-DrakesmithNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Christopher Elles ClarkExeter Collaboration for Academic Primary Care, University of Exeter, Exeter, UK.ORCID 0000-0002-7526-3038
Rebecca K BarnesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-8844-7496
Andrew Paul CleggAcademic Unit for Ageing & Stroke Research, University of Leeds, Leeds, UK.ORCID 0000-0001-5972-1097
Gary A FordHealth Innovation Oxford and Thames Valley, Oxford, UK.
Seema GadhiaHealth Innovation Oxford and Thames Valley, Oxford, UK.ORCID 0000-0003-1311-6718
William HintonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Fd Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-7976-7172
Sundus JawadNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0009-0008-3997-3025
Kamlesh KhuntiDiabetes Research Centre, University of Leicester, Leicester, UK.
Gregory Yh LipInstitute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.ORCID 0000-0002-7566-1626
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-8553-2641
Jonathan MantPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0002-9531-0268
Deborah McCahonCentre for Academic Primary Care, Population Health Sciences, University of Bristol, Bristol, UK.ORCID 0000-0003-2768-293X
Bernardo Meza-TorresNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rupert A PayneExeter Collaboration for Academic Primary Care, University of Exeter, Exeter, UK.ORCID 0000-0002-5842-4645
Rafael Perera-SalazarNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-2418-2091
Claire ReidyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-0013-6843
Anna SeeleyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Samuel SeiduDiabetes Research Centre, University of Leicester, Leicester, UK.
Katherine TuckerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-6544-8066
Rik van der VeenNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Marney Williamspatient and public advisor, London, UK.
Richard J McManusNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-3638-028X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStructured medication reviews (SMRs) were introduced in 2020 to address polypharmacy in patients most at risk of medicines-related harm.

aimTo evaluate the impact of SMRs on prescribing in primary care. DESIGN AND

settingRetrospective observational cohort study of electronic health records from patients aged ≥65 years, prescribed ≥1 medications, and fulfilling the specific eligibility criteria for an SMR, registered at practices contributing data to the Oxford Clinical Informatics Digital Hub, between 1 April 2020 and 30 September 2022.

methodThe association between SMRs and prescription changes was examined by matching individuals who received an SMR to individuals who did not receive an SMR, according to age, sex, and primary care practice, using cumulative density sampling. Analyses were undertaken using adjusted logistic regression.

resultsOf 635 698 eligible patients, 82 285 (12.9%, 95% confidence interval [CI] = 12.9 to 13.0) received ≥1 SMR during the study observation period. In those prescribed potentially inappropriate drug combinations prior to an SMR, between 12.5% and 40.0% were corrected up to 3 months later. In matched analyses, SMRs were most strongly associated with an increase in new prescriptions of angiotensin-converting enzyme inhibitors (adjusted odds ratio [aOR] 1.56, 95% CI = 1.35 to 1.81), statins (aOR 1.78, 95% CI = 1.57 to 2.02), and antidepressants (aOR 1.45, 95% CI = 1.28 to 1.63). SMRs were also most strongly associated with stopping these drug classes in those previously prescribed treatment.

conclusionSMRs were associated with starting new medications and stopping existing prescriptions compared with usual care. Further work is needed to understand if these changes improved patient outcomes.

Indexed as

Inappropriate PrescribingPractice Patterns, Physicians'Primary Health CareAgedElectronic Health RecordsEnglandFemaleHumansMalePolypharmacyRetrospective Studiesdeprescribingelectronic health recordsinappropriate prescribingpolypharmacyprimary health carestructured medication review

Identifiers

PMID41991224
PMCPMC13531492

What OpenQuestion holds

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Registered trials

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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.