356 CHAPTER 4.3 MEs was used as the denominator; 3) the proportion of MEs that resulted in a recommendation by the pharmacotherapy team to change medication regimen. The number of present MEs was used as the denominator. The numerator included both STOPP/START-based and non-STOPP/START-based recommendations. As secondary outcome, the time between the occurrence of a first potentially preventable DRA and the presence of MEs during the in-hospital medication review was evaluated. Data collection and analysis Baseline patient characteristics (e.g. age, gender, number of co-morbidities, number of medications, renal function) were prospectively collected at index hospitalisation for all OPERAM intervention patients and captured in an eCRF. Data on CDSS-generated signals and changes in medication regimens recommended by the pharmacotherapy teams were saved within the CDSS and available for analysis. Data on medical conditions was captured at index hospitalisation and at readmission. This data included diagnoses, laboratory values (e.g. renal function, sodium/potassium levels), measurements (e.g. blood pressure) and patient-reported information (e.g. pain score measured by EQ-VAS [41], drug adherence measured by MMAS-8 [42]). Data on drug use was initially registered at index hospitalisation and updated during follow-up calls within the OPERAM trial. The results of the DRA adjudication process at readmission were extracted from the eCRF for all OPERAM intervention patients. Patient data from the index hospitalisation on medical conditions, drug use, CDSSgenerated signals and pharmacotherapy teams’ recommendations were registered in an electronic data capture tool (Castor v.2021.5.5) and initially reviewed by a researcher (JI, final year pharmacy master student). Subsequently, all data and the proposed answers to the screening questions were again reviewed and validated by a second researcher (BS, hospital pharmacist, clinical pharmacologist). If MEs identified at rehospitalisation needed additional information for detectability assessment, the physician from the DRA adjudication team who had initially identified the ME was consulted to provide this information. For instance, the ME ‘underuse of analgesics in uncontrolled pain’ required additional information on the type and dosage of the underused analgesic drug. The additional information was provided using the same documents that were available at DRA adjudication. Descriptive data analysis on baseline characteristics and MEs was performed using IBM SPSS Statistics v.26.0.0.1. The time between the occurrence of a potentially preventable DRA and the presence of MEs during the in-hospital medication review was visualised using GraphPad Prism 9.
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