The objective it to study how implementation of the national policy on structured medication reviews (SMR) is impacting on the care of those with complex multimorbidity (4+ conditions) as a group with the most potential to benefit from such an intervention. The proposed evaluation will aim to: Understand how SMRs are being applied to people with complex multimorbidity; Use best practice examples along with practice dashboards to feedback performance to optimise SMRs including reducing inequalities in provision or performance; In this way to optimise the performance of SMRs for people with complex multimorbidity.
Timescale: 30 months starting on April 1st, 2021.
Outcome measures: Evidence of changes in prescribing using the STOPP/START criteria for
inappropriate and appropriate prescribing is the key outcome measure. Additional outcomes will include:
- Detailed markers of potential benefit: recording of cardiovascular risk factors, before and after SMR:
- presence of AF, blood pressure, cholesterol, monitoring tests (e.g., U&Es). Detailed markers of potential harm: anticholinergic medication index. And other outcomes (referrals, hospital admissions (including falls/fractures/cardiovascular events).