Improving medicines use in people with polypharmacy in primary care: a synopsis from the IMPPP cluster-RCT…

Randomized trialHealth and social care delivery research· Jul 2026

Improving medicines use in people with polypharmacy in primary care: a synopsis from the IMPPP cluster-RCT with pilot-feasibility study.

Rupert A Payne, Ammar Annaw, Peter S Blair … Deborah McCahon

GeriatricsRandomized trialClinical practiceQ1IF 2.8

Structured medication review did not reduce potentially inappropriate prescribing in polypharmacy patients.

Improving medicines use in people with polypharmacy in primary care: a synopsis from the IMPPP cluster-RCT with pilot-feasibility study.

Rupert A Payne … Deborah McCahon

Health and social care delivery research · Jul 2026

Background

Polypharmacy is a major challenge for patient safety and effective resource use.

Purpose

To develop, optimise and evaluate a primary care complex intervention for reducing medically defined potentially inappropriate prescribing among patients experiencing polypharmacy.

Methods

Phase 1: Qualitative interviews and focus groups with patients and professionals explored views/experiences of existing National Health Service Scotland interventions, informing development of core intervention components.

n = 50 adults

Results

no meaningful change in inappropriate prescribing versus usual care

MD -0.01 (95% CI -0.21 to 0.20)

null 0

-0.21

0.20

CI crosses the null - not significant

More results

Phase 1: Intervention component design was informed by findings related to elements of the medication review, informatics and clinician training.

Phase 2: Core intervention elements were successfully implemented in the pilot, although clinical delivery was hampered by disruptions due to the coronavirus disease pandemic.

More results

Most patients (73.2%) reported satisfaction with the review, with satisfaction strongly associated with perceptions of shared decision-making.

FUTURE WORK: Research should develop new patient-centred outcomes and identify higher-risk patients.

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Conclusion · 1 of 3

A complex medication optimisation intervention did not reduce potentially inappropriate prescribing in patients with polypharmacy.

Conclusion · 2 of 3

Findings strongly support revisiting current medication optimisation policy, with one-off structured reviews, even when enhanced with digital healthcare solutions and clinical pharmacy investment, not guaranteed to improve key clinical outcomes.

Conclusion · 3 of 3

Nevertheless, the positive

Improving medicines use in people with polypharmacy in primary care: a synopsis from the IMPPP cluster-RCT with pilot-feasibility study.

Improving medicines use in people with polypharmacy in primary care: a synopsis from the IMPPP cluster-RCT with pilot-feasibility study.

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