Intervention component | Intervention stage | ||
---|---|---|---|
 | Development | Pilot | Finalised |
Academic detailing with a pharmacist | Small, but potentially important, and relatively consistent effects on prescribing [21]. | One brief session delivered in pilot, participants instructed on review process and treatment algorithms | One session (30Â minutes) discussing: |
1) PIP | |||
2) Medicines review | |||
3) Web-based therapeutic treatment algorithms | |||
Medicines review with web-based therapeutic treatment algorithms | Medicines review identified as a strategy to address PIP [10, 28, 29]. Pharmacists have role in providing advice and support to enable GPs conduct medicines reviews [30, 31]. | Structure of treatment algorithms revised | One review per patient conducted using web-based platform which guides GP through process |
Non-pharmacological alternatives added where applicable | Each treatment algorithm has the following structure: | ||
Barriers of patient preference and time highlighted | 1) The individual PIP with reason for concern: | ||
PIP criteria selected Treatment algorithms to be more structured More focus on non-pharmacological alternatives | Structure of web-based system revised | 2) Alternative pharmacological and non-pharmacological treatment options | |
3) Background information (where relevant) | |||
Patient information leaflets | Need for information to give to patients highlighted | Patient information leaflets developed, not well utilised in pilot | Patient information leaflets: |
1) Describe the PIP and the reasons as to why it may be inappropriate | |||
Patient information leaflets may be helpful in improving patient outcomes, older patients appreciate information leaflets in addition to verbal information from their doctor [40]. | |||
2) Outline the alternative pharmacological and non-pharmacological therapies GPs may offer. |