Introduction CompreHensive geriAtRician-led MEdication Review (CHARMER) is a behaviour change intervention to support geriatricians and pharmacists to proactively deprescribe inappropriate medicines with older adults in hospital. The intervention comprises: formulating a deprescribing action plan, workshops, benchmarking reports and weekly briefings between geriatricians and pharmacists. We assessed feasibility and acceptability of the CHARMER intervention and study processes. Method A two-arm purposive allocation feasibility study was undertaken in four hospitals (three intervention, one control) in England in 2022. Data were collected to check completeness and quality, and assess intervention fidelity. Rapid qualitative analysis of staff and patient interviews, intervention implementation observations (action plan launch, pharmacist workshop and geriatrician videos), and study meeting minutes was undertaken. Results Study data were feasible to collect, of sufficient completeness and quality. Geriatrician and pharmacist principal investigators managed intervention implementation. They were able to implement most intervention components with ease and fidelity. Principal investigators felt that dedicated support for intervention implementation would better equip them with the resource and expertise to fidelitously implement all intervention components. Detailed instructions for preparing the action plan and how it might be delivered were desired. Geriatricians and pharmacists who received the intervention found it acceptable. Pharmacists felt that the weekly briefings encouraged them to dedicate time to review medicines and raise with geriatricians, opportunities to deprescribe. Geriatricians indicated that participating in CHARMER allowed them to focus on deprescribing conversations with patients and they involved junior doctors more in the deprescribing process. Conclusion(s) The CHARMER intervention and trial processes were feasible and acceptable. Revisions to support intervention implementation include providing a template action plan for hospitals to adapt; funds for a project manager one day a week to work with CHARMER principal investigators for three-months to oversee implementation, and support from Eastern Academic Health Science Network in the definitive trial (winter 2023).

中文翻译：

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1898 医院取消处方干预措施的可行性研究：综合老年人主导的药物审查 (CHARMER)

简介 由老年人主导的综合药物审查 (CHARMER) 是一项行为改变干预措施，旨在支持老年科医生和药剂师主动取消对住院老年人的不适当药物处方。干预措施包括：制定取消处方行动计划、研讨会、基准报告以及老年科医生和药剂师之间的每周简报。我们评估了 CHARMER 干预和研究过程的可行性和可接受性。方法 2022 年在英国四家医院（三家干预医院，一家对照医院）进行了两臂有目的分配可行性研究。收集数据以检查完整性和质量，并评估干预保真度。对工作人员和患者访谈、干预实施观察（行动计划启动、药剂师研讨会和老年病学家视频）以及研究会议纪要进行了快速定性分析。结果 研究数据收集可行，具有足够的完整性和质量。老年病学家和药剂师主要研究人员负责管理干预措施的实施。他们能够轻松、保真地实施大多数干预措施。主要研究人员认为，对干预措施实施的专门支持将更好地为他们提供资源和专业知识，以忠实地实施所有干预措施。需要有关准备行动计划以及如何实施该计划的详细说明。接受干预的老年病学家和药剂师认为这是可以接受的。药剂师认为，每周的简报会鼓励他们花时间审查药物，并向老年科医生提出取消处方的机会。老年病学家表示，参与 CHARMER 使他们能够专注于与患者进行取消处方对话，并且让初级医生更多地参与取消处方过程。结论 CHARMER 干预和试验过程是可行且可接受的。支持干预实施的修订包括提供模板行动计划供医院适应；资助一名项目经理每周有一天与 CHARMER 主要研究人员一起工作三个月，以监督实施情况，并在最终试验（2023 年冬季）中得到东部学术健康科学网络的支持。