342 CHAPTER 4.2 with, primary care physicians are needed to assess whether the clinical setting and the health care professional involved have significant influence on recommendation agreement, implementation, monitoring and prevention of adverse events within this population. Conclusion Hospital physicians’ and older patients’ agreement with individualised STOPP/ START based medication optimisation recommendations after discussion with a pharmacotherapy team was approximately 60%. Highest agreement was found for initiation of osteoporosis drugs and stopping of PPIs. Female gender, history of falls and eGFR 30-50 ml/min/1.73m2 were significantly associated with higher agreement levels with proposed medication adjustments. Patients’ own reluctance to change (40%) was the most important reason for disagreement. Better patient and physician education regarding the benefit/risk balance of pharmacotherapy in addition to more precise and up-to-date medical records will likely result in higher agreement with and implementation of pharmacotherapy optimisation recommendations in the future.
RkJQdWJsaXNoZXIy MTk4NDMw