National roll-out of the Goal-directed Medication review Electronic Decision Support System (G-MEDSS)© in practice

Abstract

Background: The Goal-directed Medication review Electronic Decision Support System (G-MEDSS)© provides guidance for clinicians conducting medication reviews, to tailor care to meet their patients’ goals. G-MEDSS consists of The Goals of Care Management Tool (GCMT), The Drug Burden Index (DBI) Calculator©, and the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire. 

Aims: To describe the 1) users of G-MEDSS; 2) clinical settings where G-MEDSS was used; and 3) patients for whom G-MEDSS was used; during this implementation study.

Methods: Prospective cross-sectional evaluation. Clinicians were invited to register and use G-MEDSS within their clinical practice settings. De-identified data about the users and their patients were collected through the website and descriptively analysed.

Results: During the roll-out 129 participants(115 pharmacists and 14 medical practitioners) registered to use G-MEDSS, with most participants from NSW(n=35, 27%). These participants used G-MEDSS for 95 patients (mean age(SD) 76.8(11.3)), during medication reviews in the home (n=60,63%) and residential care (n=27, 28%). Participants used the GCMT, the DBI Calculator and rPATD for n=28(29%), n=90(95%), and n=23(24%) of patients, respectively. The most common goal reported by patients was “optimising quality of life” (n=23, 36.5%). The mean(SD) DBI score for patients was 1.41(1.1) and the proportion of patients who said that they would be willing to have a medication deprescribed if their doctor recommended it was 82.6%(n=19).

Conclusions: G-MEDSS, predominately The DBI Calculator, is being used within clinical practice primarily by pharmacists to support medication review in the home. Further qualitative studies will determine the barriers and enablers to wider use.