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iSIMPATHY: a multinational pre-post non-randomised intervention study transforming medication review.

Alpana Mair1,2, Ciara Kirke3, Michael G Scott4

  • 1Effective Prescribing and Therapeutics Division, Scottish Government, Edinburgh, Scotland, UK Alpana.Mair@gov.scot.

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|November 17, 2025
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Summary
This summary is machine-generated.

Pharmacist-led medication reviews using the 7-Steps approach improved medication appropriateness and patient outcomes. This person-centred strategy demonstrated significant clinical benefits and cost savings, proving its value in polypharmacy management.

Keywords:
Medication ReviewPatient-Centered CarePolypharmacy

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Area of Science:

  • Pharmacology
  • Health Services Research
  • Patient Care

Background:

  • Polypharmacy, the use of multiple medications, presents challenges in patient care.
  • The iSIMPATHY project introduced a 7-Steps person-centred approach for medication reviews.
  • This approach aimed to optimize drug treatment and support patient well-being.

Purpose of the Study:

  • To evaluate the effectiveness of pharmacist-led, comprehensive, person-centred medication reviews.
  • To assess the impact of the 7-Steps methodology on polypharmacy management.

Main Methods:

  • The iSIMPATHY project implemented a standardized approach for polypharmacy management.
  • Person-centred medication reviews were conducted in primary care, hospital, and outpatient settings.
  • The methodology built upon recommendations from the SIMPATHY project.

Main Results:

  • 82% of interventions were clinically significant, with 4% potentially preventing severe adverse events.
  • Average medication count decreased from 12 to 11, with 92% of reviews improving medication appropriateness.
  • Significant healthcare resource utilization benefits were observed, including a positive return on investment and a quality-adjusted life year gain of 7.4 per 100 patients.

Conclusions:

  • Pharmacist-led, 7-Steps medication reviews positively impacted medication numbers, appropriateness, and clinical outcomes.
  • The service generated cost savings that exceeded its expenditure.
  • The approach is scalable, supported by developed tools and resources.