A mixed methods analysis of the medication review intervention centered around the use of the 'Systematic Tool to Reduce Inappropriate Prescribing' Assistant (STRIPA) in Swiss primary care practices.

Jungo, Katharina Tabea; Deml, Michael J; Schalbetter, Fabian; Moor, Jeanne; Feller, Martin; Vidonscky Lüthold, Renata; Huibers, Johanna Alida Corlina; Sallevelt, Bastiaan Theodoor Gerard Marie; Meulendijk, Michiel C; Spruit, Marco; Schwenkglenks, Matthias; Rodondi, Nicolas; Streit, Sven (2024). A mixed methods analysis of the medication review intervention centered around the use of the 'Systematic Tool to Reduce Inappropriate Prescribing' Assistant (STRIPA) in Swiss primary care practices. BMC health services research, 24(1), p. 350. BioMed Central 10.1186/s12913-024-10773-y

Jungo_BMCHealthServRes_2024.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB) | Preview


Electronic clinical decision support systems (eCDSS), such as the 'Systematic Tool to Reduce Inappropriate Prescribing' Assistant (STRIPA), have become promising tools for assisting general practitioners (GPs) with conducting medication reviews in older adults. Little is known about how GPs perceive eCDSS-assisted recommendations for pharmacotherapy optimization. The aim of this study was to explore the implementation of a medication review intervention centered around STRIPA in the 'Optimising PharmacoTherapy In the multimorbid elderly in primary CAre' (OPTICA) trial.


We used an explanatory mixed methods design combining quantitative and qualitative data. First, quantitative data about the acceptance and implementation of eCDSS-generated recommendations from GPs (n = 21) and their patients (n = 160) in the OPTICA intervention group were collected. Then, semi-structured qualitative interviews were conducted with GPs from the OPTICA intervention group (n = 8), and interview data were analyzed through thematic analysis.


In quantitative findings, GPs reported averages of 13 min spent per patient preparing the eCDSS, 10 min performing medication reviews, and 5 min discussing prescribing recommendations with patients. On average, out of the mean generated 3.7 recommendations (SD=1.8). One recommendation to stop or start a medication was reported to be implemented per patient in the intervention group (SD=1.2). Overall, GPs found the STRIPA useful and acceptable. They particularly appreciated its ability to generate recommendations based on large amounts of patient information. During qualitative interviews, GPs reported the main reasons for limited implementation of STRIPA were related to problems with data sourcing (e.g., incomplete data imports), preparation of the eCDSS (e.g., time expenditure for updating and adapting information), its functionality (e.g., technical problems downloading PDF recommendation reports), and appropriateness of recommendations.


Qualitative findings help explain the relatively low implementation of recommendations demonstrated by quantitative findings, but also show GPs' overall acceptance of STRIPA. Our results provide crucial insights for adapting STRIPA to make it more suitable for regular use in future primary care settings (e.g., necessity to improve data imports).


Clinicaltrials.gov NCT03724539, date of first registration: 29/10/2018.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Jungo, Katharina Tabea, Moor, Jeanne Yvonne, Feller, Martin, Vidonscky Lüthold, Renata, Rodondi, Nicolas, Streit, Sven


300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health




BioMed Central


[4] Swiss National Science Foundation




Pubmed Import

Date Deposited:

27 Mar 2024 09:56

Last Modified:

11 Apr 2024 09:46

Publisher DOI:


Related URLs:

PubMed ID:


Uncontrolled Keywords:

Electronic clinical decision support system Medication optimization Mixed methods research Multimorbidity Polypharmacy Primary care





Actions (login required)

Edit item Edit item
Provide Feedback