159 DOES SHARED DECISION MAKING (SDM) ADDRESS POTENTIALLY INAPPROPRIATE PRESCRIBING (PIP)?

Abstract

Abstract Background Potentially Inappropriate Prescribing (PIP) as identified by STOPP/START criteria is associated with poor patient outcomes. The objective of this study was to investigate the extent of reduction in PIP achieved by Shared Decision Making (SDM) employed by pharmacists delivering, comprehensive, person-centred medication reviews as part of the EU INTERREG-VA funded iSIMPATHY project. The relationship between reductions in PIP and improvements in the iSIMPATHY Patient Reported Outcome Measures (PROMs) was explored. Methods This study was conducted across 3 General Practice (GP) practice sites. List of eligible patients aged ≥65 years and on ≥10 regular medications were generated from practice software. Patients were contacted by phone and offered iSIMPATHY reviews and consented to data collection. The first 100 iSIMPATHY reviews actioned by the GPs and for which post review PROM data was collected were included. Data was independently reviewed and analysed by the Medication Safety, Quality Improvement Division of the Health Service Executive. Results At least one STOPP/START criteria was identified in 93% of study participants and an average of 4 per patient, were found. 76% of these were resolved within the study timeframe. 88% of patients reported an improvement in at least one PROM domain. 76% reported an improvement in their Understanding, 54% in their experience of Adverse Drug Reactions (ADRs), 21% in their Activities of Daily Living (ADLs) and 8% in adherence. 68% of STOPP/START criteria were resolved for the 53% patients reporting improvements in 0-1 PROM domains, whereas 85% were resolved for the 47% reporting improvements in 2-4 domains. Conclusion Delivery of the iSIMPATHY medication review service in the Irish GP practice setting significantly improves both medicines appropriateness and Patient Reported Outcome Measures (PROMs). There appears to be a positive relationship between the extent in reduction in PIP achieved by SDM and reported improvements in PROMs. The relationship between PROM outcomes and individual PIP criteria warrants further investigation.