277 Frequency and acceptance of CDSS-generated STOPP/START signals with more than nine and between seven and nine co-morbidities, respectively. For setting-related determinants, the acceptance differed significantly between the participating trial sites. Compared with Switzerland, the acceptance was higher in Ireland (STOPP: + 26.8%; 95% CI 16.8–36.7; START: + 31.1%; 95% CI 18.2–44.0) and in the Netherlands (STOPP: + 14.7%; 95% CI 7.8–21.7). Admission to a surgical ward was positively associated with acceptance of STOPP signals (+ 10.3%; 95% CI 3.8–16.8). Conclusion An expert team’s involvement in translating population-based CDSS signals to individual patients is essential, as more than half of the signals for potential overuse, underuse and misuse were not deemed clinically appropriate in a hospital setting. Patient-related potential determinants were poor predictors of acceptance. Future research investigating factors that affect patients’ and physicians’ agreement with medication changes recommended by expert teams may provide further insights for implementation in clinical practice. 4
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