Table 1

Inclusion and exclusion criteria of the OPERAM trial and the embedded mixed-methods study (created by the authors)

OPERAM trialMixed-methods study embedded in OPERAM
Inclusion criteria:
  • 70 years or older.

  • Multimorbidity (≥3 chronic conditions ≥6 months).

  • Polypharmacy (≥5 chronic medications).

Exclusion criteria:
  • Direct admission to palliative care.

  • Report of a structured medication review within the last 2 months.

The OPERAM intervention consisted of the Structured Method to Reduce Inappropriate Prescribing including structured history taking of medication use, a CDSS-assisted medication review based on the STOPP/START V.2 criteria, discussion of medication optimisation recommendations with the attending physician and the patient and generation of a discharge report with recommendations for the GP.
The control arm received usual care.
Inclusion criteria:
  • ≥1 change in chronic medication proposed during hospitalisation, for example, the addition, discontinuation or modification of a medicine. The medication change could be a result of the OPERAM intervention or usual care.

  • Informative patients willing to share their experience.

Exclusion criteria:
  • Inability to provide informed consent.

  • Patients with confusion, dementia or severe cognitive impairment.

  • Unacceptable living distance from the clinical sites (for pragmatic reasons).

  • CDSS, Clinical Decision Support System; GP, general practitioner; START, Screening Tool to Alert to Right Treatment; STOPP, Screening Tool of Older People’s Prescriptions.