Results
COPD
CHRONIC OBSTRUCTIVE PULMONARY DISEASE, COPD, SAID, FIRE
Forty three general practitioners working in Swiss primary care practices participated in the OPTICA trial (supplementary figure A).CONSORT patient flowchart. *For these patients, drag/drop function in Systematic Tool to Reduce Inappropriate Prescribing Assistant (STRIPA) had not been used or was reset after intervention. †Reasons are that patients did not see their general practitioner (GP) or had other urgent healthcare needs that had to be prioritised. ‡Referring to follow-up calls by phone. Time windows for these phone calls were +15 days at baseline, +/–30 days at six month follow-up, and +/–30 days at 12 month follow-up. For all patients, except those who withdrew from study, available data from FIRE database could be used (provided that patient continued seeing same GP). §Multiple criteria can apply. Multiple imputed data were used for analysesParticipating general practitioners had a median age of 53 (44-58) years and median work experience of 14 (7-21) years, and 21% were female. At baseline, patients had a median number of long term medications of 7 (4-10) and a median number of chronic diagnoses of 7 (4-10). The baseline characteristics of patients were similar in the two groups, except for appropriateness of medication, which was greater in the control group (as shown by the lower total MAI) (Characteristics of general practitioners (GPs) and patients at baseline. Values are numbers (percentages) unless stated otherwiseIQR=interquartile range; MAI=Medication Appropriateness Index.Missing values: 0 for all GP characteristics, except for number of consultations per day (2%); 0 for all patient characteristics except for education level (3%), smoking status (2%), smoking consumption (2%), living situation (2%), falls (4%), number of hospital admissions (3%), quality of life (8%), both primary outcomes MAI and Assessment of Underutilisation (AOU) at baseline (7%).Measured by visual analogue scale of European Quality of Life-5 Dimensions questionnaire (EQ-VAS). Values range from 0 to 100, with higher values indicating higher quality of life.Measured by agreement with statement “I would be willing to stop one or more of my medicines if my doctor said it was possible” of revised Patients’ Attitudes Towards Deprescribing (rPATD).Adapted from Samsa, et al.Averaged by number of chronic medications.Measured by AOU based on Jeffery et al.Averaged by the number of chronic conditions.An average of 5.4 prescribing recommendations per patient were generated, of which an average of 3.7 were STOPP or START recommendations (Recommendations generated by Systematic Tool to Reduce Inappropriate Prescribing Assistant (STRIPA) to optimise prescribing in older adults (n=133)SD=standard deviation; START=Screening Tool to Alert to Right Treatment; STOPP=Screening Tool of Older Persons’ Prescriptions.Information collected from STRIPA for 133/160 patients in intervention group for whom drag/drop function in STRIPA had been used as part of intervention. All patients for whom information could be retrieved from STRIPA had ≥1 recommendation to start or stop one or several of their medications.Includes recommendations to stop and start medications, adapt dosage of potentially inappropriate prescriptions, or flag drug-drug interactions.All patients for whom information could be retrieved from STRIPA had ≥1 recommendation to start or stop one or several of their medications.This information was reported by 7 general practitioners from OPTICA intervention group about 53 patients, which explains lower denominator.Most common prescribing recommendations generated by Systematic Tool to Reduce Inappropriate Prescribing Assistant of 704 recommendations madeACE=angiotensin converting enzyme; ARB=angiotensin receptor blocker; COPD=chronic obstructive pulmonary disease.Recommendations that were generated ≥5 times during study are shown.