Bastiaan Sallevelt

Table of contents Chapter 1 General Introduction 9 Chapter 2 Applicability of tools for medication optimisation in hospitalised older people 31 2.1 Performance of a trigger tool for detecting adverse drug reactions in patients with polypharmacy acutely admitted to the geriatric ward 33 2.2 Evaluation of clarity of the STOPP/START criteria for clinical applicability in prescribing for older people: A quality appraisal study 59 2.3 Conversion of STOPP/START version 2 into coded algorithms for software implementation: A multidisciplinary consensus procedure 111 Chapter 3 Process development and clinical outcomes of in-hospital medication reviews 193 3.1 Intervention protocol: OPtimising thERapy to prevent avoidable hospital Admission in theMulti-morbid elderly (OPERAM): a structuredmedication review with support of a computerised decision support system 195 3.2 Optimizing therapy to prevent avoidable hospital admissions in multimorbid older adults (OPERAM): cluster randomised controlled trial 219 Chapter 4 Evaluation of the in-hospital medication review process 273 4.1 Frequency and acceptance of clinical decision support systemgenerated STOPP/START signals for hospitalised older patients with polypharmacy and multimorbidity 275 4.2 Hospital physicians' and older patients' agreement with individualised STOPP/START-based medication optimisation recommendations in a clinical trial setting 325 4.3 Detectability of medication errors with a STOPP/START-based medication review in older people in the year prior to a potentially preventable drug-related admission 349 Chapter 5 General Discussion 389 Chapter 6 Summary 427 Chapter 7 Nederlandse samenvatting 435 Chapter 8 Appendices 447 Chapter 9 Dankwoord 459