Experiences and challenges of implementing clinical medication reviews in daily practice: a mixed-methods study

Organisational problems still prevent widespread implementation of clinical medication reviews. The Opti-Med2 method was developed to facilitate the process of performing clinical medication reviews. The method includes patient involvement by means of a questionnaire and expert teams of community pharmacists and general practitioners (GPs) to perform pharmacotherapeutic analyses, providing the patients' own GP with pharmacotherapeutic advice. There is a supporting role of community pharmacy technicians and general practice nurses/assistants in the process.

To gain insight into the implementation of the Opti-Med2 method within the framework of pharmacotherapeutic audit meeting groups in the Netherlands.

A mixed-methods implementation study in seven groups of primary care healthcare providers. Quantitative data were collected using study forms. Semi-structured interviews with 8 GPs, 5 community pharmacists and 2 community pharmacy technicians were held. Interviews were transcribed verbatim and were analysed using the extended Normalization Process Theory.

Only one group provided sufficient quantitative data for analysis. Of the pharmacotherapeutic advice given by the expert team, 72% was adopted by the GPs of which 85% resulted in an intervention with the patient. In general, the healthcare providers were satisfied with using the Opti-Med2 method. The use of expert teams was appreciated by most GPs and community pharmacists. All healthcare providers were very satisfied with the use of the patient questionnaire.

Although full implementation of Opti-Med2 method as a whole was not achieved, the structured organisation of conducting CMRs and the use of questionnaires was deemed successful.