331 Hospital physicians’ and older patients’ agreement with individualised STOPP/START recommendations analysis did not result in START/STOPP recommendations. In 22 patients, discussion with patient and physician was not performed and for 16 patients recommendations were only discussed with the attending physicians and not with the patients. These 16 patients were excluded from the final analysis. For 139 of the 155 eligible patients (89.7%), the medication review including discussion with both patient and attending physician was successfully completed. These 139 patients comprised the study population. A flowchart illustrating the data flow is presented in Figure 2. The mean (SD) age of the study population was 78.3 (5.1) years, 65 patients (47%) were male and the median (IQR) number of prescribed long term daily medications prior to admission was 11 (9-14). All baseline characteristics are presented in Table 1. CDSS-assisted pharmacotherapy analysis by the PT resulted in a total of 371 recommendations for 139 patients, comprising 237 STOPP recommendations (median (IQR): 1 (1-2) per patient) and 134 START (1 (0-1) per patient) recommendations. Overall STOPP/START recommendation agreement was 61.2%, with no significant difference in agreement proportion between STOPP (61.6%) and START (60.7%) recommendations. Figure 2. Study population flowchart. Non-eligible patients did not fulfil the inclusion criteria of this OPERAM substudy i.e. discussion of recommendations with patient and attending physician in order to determine agreement with recommendations. 4
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