Table 2.

Descriptions and examples of medication review, training, tool/instrument(s) and feedback and audit

Intervention element	Definition	Subtypes	Code	Example	BCW intervention function(s)
Medication review	‘Structured evaluation of patient‘s medicines with the aim of optimising medicines use and improving health outcomes’.42	Pharmacist-led with feedback to physician	MR1	Clinical pharmacists performed drug therapy reviews for patients identified with a high risk of polypharmacy and suggested drug therapy changes to the physicians by telephone, fax or in person. Physicians reviewed and endorsed recommendations.43	Persuasion Environmental restructuring Enablement
		Performed by pharmacist and physician	MR2	Clinical pharmacist reviewed patient charts to determine patients at greatest risk for MRPs and worked side by side with physicians to consult patient and resolve MRPs.44	Environmental restructuring Enablement
		Performed by an external team of pharmacist(s) and/or physician(s)	MR3	A panel of five experts (physicians and pharmacists) not affiliated with the MCO or the academic medical centre performed a peer review of the drugs to be included in the intervention and their corresponding alternative medications.45	Persuasion Environmental restructuring Enablement
		Performed by pharmacist (but not the one conveying feedback)	MR4	A clinical pharmacologist performed a thorough medication review of the selected patients, which was sent to the medication consultant. The medication consultant offered a visit to the general practitioner to discuss potential changes to the individual patient’s medication.46.	Persuasion Environmental restructuring Enablement
		Performed by physician	MR5	A letter was sent to selected patients to encourage them to make an appointment with their primary care physician for a medication review. Physicians were provided with patient-specific medication management report and clinical practice guidelines for managing polypharmacy.47	Enablement
		Performed by physician and medical assistant	MR6	MA performed brown bag review and GPs reviewed the medication systematically using tools (PRISCUS list or MAI) to reduce potentially inappropriate medications.48	Environmental restructuring Enablement
Training	Imparting skills required to carry out intervention to improve prescribing.28	For pharmacists	TG1	Pharmacists attended tutorial by the study pharmacist to ensure standardised method of medication review.49	Training
		For physicians	TG2	20 GPs were trained to use STOPP criteria.50	Training
		For medical assistants	TG3	MAs were trained to perform brown bag reviews.48	Training
Tool/instrument (s)	Checklist/guideline(s) used to identify medication-related problems or measure medication appropriateness.	–	TI1	Pharmacist identified potential MRPs using START/STOPP criteria to be addressed with the provider.51	Enablement
Feedback and audit	Monitoring and evaluation of physician’s prescribing patterns.	Feedback only	FA1	Retrospective DUR identified patients at risk of drug injury. Main prescribing GP of the identified patient received a personalised feedback letter containing patient-specific information and clinical practice guidelines.52	Persuasion
		Feedback with the discussion of improvement strategies	FA2	A quality improvement tool was used to track PIP and individualised feedback were mailed to PCPs monthly. A geriatrician and geriatric clinical pharmacist met face-to-face with each PCP to review his/her first feedback form and discuss improvement strategies.53	Persuasion Environmental restructuring

BCW, behaviour change wheel; DUR, drug utilisation review; GP, general practitioner; MA, medical assistant; MAI, medication appropriateness index; MCO, managed care organisation; MRP, medication-related problem; PCP, primary care provider; PIP, potentially inappropriate prescribing; START, screening tool to alert to right treatment; STOPP, screening tool of older person’s potentially inappropriate prescriptions.