Development of a complex medication review intervention based on the secondment of a clinical pharmacist in general practice

Abstract

Background Medication reviews (MRs) are a well-described initiative that improves several health outcomes for polypharmacy patients. It is a complex process that can include several elements and different healthcare professionals. When developing complex interventions, it is essential to describe the development process to ensure transparency and avoid research waste. Thus, this study aimed to describe the steps of developing an MR intervention targeting general practice to ensure transparency and transferability. Methods A stepwise approach inspired by the Medical Research Council framework was utilised in the process, covering two phases, i.e. development and feasibility, and five steps: 1) intervention drafting, 2) expert opinion feedback, 3) pilot testing, 4) pilot evaluation and 5) feasibility evaluation. Results Based on the results from the first three steps, four main themes were identified: general practitioner resources, patient involvement, implementation difficulties and interdisciplinarity. These themes guided the pilot evaluation in step 4. Lastly, the feasibility of the MR intervention was evaluated in step 5 through qualitative observations and semi-structured interviews of participants (not included in this study). Conslusion This study summarised the development and evaluation of a feasible, complex MR intervention utilising clinical pharmacists in general practice in a real-life setting.