Potentially inappropriate medications are associated with polypharmacy and polypathology.
Some interventions such as pharmacotherapy reviews have been designed to reduce the prescribing of
inappropriate medications. The objective of this study is to evaluate how e ective a decision-making
support tool is for determining medication appropriateness in patients with one or more chronic
diseases (hypertension, dyslipidaemia, and/or diabetes) and polypharmacy in the primary care
setting. For this, a quasi-experimental study (randomised, controlled and multicentre) has been
developed. The study compares an intervention group, which assesses medication appropriateness
by applying a decision support tool, with a control group that follows the usual clinical practice.
The intervention included a decision support tool in paper format, where participants were informed
about polypharmacy, inappropriate medications, associated problems and available alternatives,
as well as shared decision-making. This is an informative guide aimed at helping patients with
decision-making by providing them with information about the secondary risks associated with
inappropriate medications in their treatment, according to the Beers and START/STOPP criteria. The
outcome measure was the proportion of medication appropriateness. The proportion of patients who
confirmed medication appropriateness after six months of follow-up is greater in the intervention group
(32.5%) than in the control group (27.9%) p = 0.008. The probability of medication appropriateness,
which was calculated by the proportion of drugs withdrawn or replaced according to the STOPP/Beers
criteria and those initiated according to the START criteria, was 2.8 times higher in the intervention
group than in the control group (OR = 2.8; 95% CI 1.3–6.1) p = 0.008. In patients with good adherence
to the treatment, the percentage of appropriateness was 62.1% in the shared decision-making group
versus 37.9% in the control group (p = 0.005). The use of a decision-making support tool in patients
with potentially inappropriate medications increases the percentage of medication appropriateness
when compared to the usual clinical practice.