Table 3.

Descriptions and examples of medication therapy management, shared decision-making, clinical decision support, education and patient interview

Intervention element	Definition	Subtypes	Code	Example	BCW intervention function(s)
Medication therapy management	‘Providing verbal education and training designed to enhance patient understanding and appropriate use of his/her medications’.54	–	MTM1	Patients will be provided with comprehensive counselling and specific adherence strategies (information about medications and administration) by the pharmacist.55	Education
Shared decision-making	Narrative-based dialogue between doctor and patient to discuss treatment targets and priorities of the patient.56	–	SDM1	GPs met with patients three times within 12 months. The first session was aimed at identifying patients’ priorities in life (including non-medical goals) and carving out treatment targets based on this information. The second session involved a ‘brown bag review’. On the third session, GPs discussed with patients about goal attainment, changes in medication and treatment targets for the future.56	Enablement
Clinical decision support	‘Technological applications that provide clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and healthcare’.57	–	CDS1	GP recorded medication and diagnoses in STRIPA and performed a structured drug review using the software. STRIPA is a Dutch software-based tool that 1) highlights predictable adverse medication effects, 2) advises safe and appropriate therapy using STOPP/START criteria, 3) monitors for interactions and 4) provides appropriate dosing in accordance with renal function.58	Environmental restructuring Enablement
Education	Increasing knowledge or understanding about PIP.28	For physicians	ED1	Physicians in the intervention group received: (1) a detailed educational brochure listing potentially inappropriate medications, (2) a list of suggested alternative medications (independently suggested and reviewed by five geriatricians and pharmacists not affiliated with the MCOs).45	Education
		For physicians and nurses	ED2	PCPs and nurses underwent tutorial on PIP.59	Education
Patient interview	‘Asking patient about how, when and why the patient takes each medication, as well as about any adverse reactions, allergies or issues with medication cost the patient may have experienced’.60	Performed by physician	PI1	During the consultation, patients were interviewed on drugs currently being taken, dosage and frequency and the condition for which the medication had been prescribed.61	Enablement
		Performed by healthcare professional other than physician	PI2	Patients received a 30–60 minute face-to-face consultation with the pharmacist at the clinic. Prior to the consultation, pharmacist reviewed patient's medical records. During the consultation, pharmacists interviewed patients for medication history, adherence and knowledge.62	Environmental restructuring Enablement

BCW, behaviour change wheel; GP, general practitioner; MCO, managed care organisation; 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; STRIPA, systematic tool to reduce inappropriate prescribing-assistant.