Abstract
Background
People prescribed multiple medications need regular review to optimise medication and improve health outcomes. While the most effective method to improve inappropriate polypharmacy remains unclear, medication reviews incorporating patient-centred care and shared decision-making are believed key to achieving optimal outcomes.
Aim
To explore patients’ experiences of an intervention to deliver patient-centred polypharmacy medication review in primary care.
Design and Setting
A mixed-methods process-evaluation was undertaken within the Improving Medicines use in People with Polypharmacy in Primary Care (IMPPP) randomised controlled trial conducted in the Bristol and West Midlands regions of England.
Method
Participants receiving the intervention were invited to complete a patient-experience survey. Additionally, survey respondents were purposively sampled and invited to participate in an interview and/or audio-recording of their medication review, to explore views and experiences.
Results
Survey response rate was 72.5% (N=556); 28 patients were interviewed, and 27 reviews were recorded. Overall, 73.2% of survey respondents were satisfied with their review, strongly associated with shared decision making, and 80% expressed satisfaction with how the review was delivered (primarily pharmacist-led telephone consultations). Most audio-recordings of reviews demonstrated collaborative decision making. Patients particularly valued reviews when they felt well-informed, prepared, and received clear follow-up. Pharmacist-led delivery was generally acceptable, though unfamiliarity with the reviewer and concerns about prescribing authority were perceived negatively.
Conclusion
Participants were highly satisfied with their review, although this may be contingent on appropriate preparation and support. Findings highlight the importance of clear communication throughout, and how the clinician role and familiarity shape patient experience. A person-centred review approach has the potential to improve patient experience, satisfaction, and engagement
People prescribed multiple medications need regular review to optimise medication and improve health outcomes. While the most effective method to improve inappropriate polypharmacy remains unclear, medication reviews incorporating patient-centred care and shared decision-making are believed key to achieving optimal outcomes.
Aim
To explore patients’ experiences of an intervention to deliver patient-centred polypharmacy medication review in primary care.
Design and Setting
A mixed-methods process-evaluation was undertaken within the Improving Medicines use in People with Polypharmacy in Primary Care (IMPPP) randomised controlled trial conducted in the Bristol and West Midlands regions of England.
Method
Participants receiving the intervention were invited to complete a patient-experience survey. Additionally, survey respondents were purposively sampled and invited to participate in an interview and/or audio-recording of their medication review, to explore views and experiences.
Results
Survey response rate was 72.5% (N=556); 28 patients were interviewed, and 27 reviews were recorded. Overall, 73.2% of survey respondents were satisfied with their review, strongly associated with shared decision making, and 80% expressed satisfaction with how the review was delivered (primarily pharmacist-led telephone consultations). Most audio-recordings of reviews demonstrated collaborative decision making. Patients particularly valued reviews when they felt well-informed, prepared, and received clear follow-up. Pharmacist-led delivery was generally acceptable, though unfamiliarity with the reviewer and concerns about prescribing authority were perceived negatively.
Conclusion
Participants were highly satisfied with their review, although this may be contingent on appropriate preparation and support. Findings highlight the importance of clear communication throughout, and how the clinician role and familiarity shape patient experience. A person-centred review approach has the potential to improve patient experience, satisfaction, and engagement
| Original language | English |
|---|---|
| Journal | British Journal of General Practice |
| Early online date | 25 Jun 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 25 Jun 2025 |
Keywords
- polypharmacy
- clinical trial
- medicines optimisation
- general practice
- qualitative/ process evaluation