Table 1 Summary of OPTI-SCRIPT intervention and control groups

(1) Academic detailing with a pharmacist

One session (30 min) where a pharmacist visited the practice to discuss PIP, medicine review and the web-based pharmaceutical treatment algorithms

(2) Medicine review with web-based pharmaceutical treatment algorithms. GPs were asked to conduct one eview per patient using the web-based platform to guide them through the process. The GP was presented with the specific PIP drug(s) for each patient, and for each PIP drug, there was a treatment algorithm with the following structure:

a. The individual PIP with reason for concern

b. Alternative pharmacological and non-pharmacological treatment options

c. Background information (where relevant)

(3) Patient information leaflets to give to patients during the review. Each leaflet:

a. Described the PIP and the reasons as to why it may be inappropriate

b. Outlined the alternative pharmacological and non-pharmacological therapies GPs may offer

Control

Control practices delivered usual care. Usual care for public general medical services (GMS) patients allows GPs to give a prescription on a monthly or three monthly basis.

Control practices received simple patient-level PIP postal feedback in the form of a list summarising the medication class to which the individual patient’s potentially inappropriate medication belonged.

Control practices did not receive an academic detailing visit or were not prompted to carry out medicines review with the individual patients.