Final recommendations (MTM intervention group only)
After 1:1 stratified randomization, study pharmacists met with the participant and study clinician to deliver the MTM intervention. During the intervention, the team gathered further information from the patient and discussed baseline recommendations together, in-person, with additional context provided by the participant on their health status, needs, and preferences. Because health status and medication use in participants may have changed in the time between the baseline assessment and the initial MTM recommendation, comparison of baseline to final recommendations was limited to those baseline MTM recommendations that proposed medication changes at the time of the initial MTM study visit. The non-medication related recommendations (see supplementary material for additional information) were discussed during the team MTM intervention, but they were not included in the present analysis.Participant responses to each final MTM recommendation for participants randomized to the MTM intervention were collected at the conclusion of the initial MTM intervention visit using a standardized form where the participant selected his or her response to the recommendation as 1) willing to change, 2) refusing to change, 3) needing to confer with a primary care provider or other specialist (e.g., cardiologist), or 4) not applicable (e.g., the participant had already discontinued the medication, dose adjustment was no longer warranted per clinical judgement). In this manuscript we are describing in detail the immediate participant response as recorded following the baseline intervention. The impact of the intervention on medication appropriateness is described in detail elsewhere [