321 Frequency and acceptance of CDSS-generated STOPP/START signals - SI SUPPLEMENTARY INFORMATION SI3 OPERAM trial results in relation to this substudy In this Supplementary Information, differences in results provided in themainOPERAM trial paper [1] and this substudy will be elaborated. Different choices were made in the substudy to define the study population and to define the term ‘recommendations’ compared to the OPERAMmain trial. OPERAM trial In the OPERAM trial paper, intervention patients were eligible for analysis when they ‘received the allocated intervention’ (n=916, Fig 1, Table 2) [1] which was defined by: 1) Having received an in-hospital pharmacotherapy (=first) analysis prior to discussion with the attending hospital physician and the patient AND/OR 2) Having received a second pharmacotherapy analysis to generate a discharge report for the general practitioner (GP) Substudy In this substudy, the aimwas to determine the frequency of CDSS generated STOPP/ START signals and subsequent acceptance by a pharmacotherapy team for in-hospital use, prior to discussion with the attending hospital physician and patient. Therefore, patients (n=826) from the OPERAM intervention group were selected for whom: 1) An in-hospital pharmacotherapy (=first) analysis was performed prior to discussion with the attending hospital physician and the patient AND 2) Data of the in-hospital pharmacotherapy analysis was available in the CDSS SI3 - Figure SI3.1 shows a visual presentation of the definition for the term ‘recommendations’ used in de OPERAM trial paper and this substudy in relation to the OPERAM intervention. Reference 1. Blum MR, Sallevelt BTGM, Spinewine A, Mahony DO, Feller M, Baumgartner C, et al. Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial. BMJ 2021;374:n1585. https:// doi.org/10.1136/bmj.n1585. 4
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