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Background: Patients with polypharmacy are at increased risk of medication-related harm. Medication reviews aim to reduce these risks but are difficult to implement in routine general practice (GP). Therefore, participatory approaches have been proposed involving stakeholders in developing intervention components tailored to patients at risk of medication-related harm and suitable for everyday GP. Various methods are used to facilitate stakeholder participation, and their applicability in different contexts requires testing. In CAN/USA, deliberative consultations with health professionals and patients have been successfully used for the development of practice-change interventions. Deliberative consultations, based on the concept of deliberative democracy, are conducted as informed group debates with minimal moderator interaction to avoid researcher influence. Such settings ensure a high level of stakeholder engagement and increase the relevance and utility of the evidence produced in the GP context.

Aim/research question: Is the methodology of deliberative consultations with health professionals and patients applicable in Germany to support the participatory development of interventions targeting medication-related harm in general practice?

Point of discussion: What are the potential barriers and pitfalls of deliberative consultations in the German context, and how can they be mitigated?

Contents: The study is part of TARGET-ADE (Innov. Fonds, Fkz 01VSF24022). We will conduct deliberative consultations with stakeholders (general practitioners, specialists in internal/emergency medicine/geriatrics, pharmacists, MFAs, patients) in two phases: Phase 1 involves four homogeneous groups of professionals and one group of patients, with the aim of reaching a working agreement on the feasibility of evidence-based intervention components. In Phase 2, a mixed stakeholder group, including representatives from each profession and patients, will discuss the implementability of the interventions deemed feasible by small groups until agreement is reached. We will test the final intervention components in a pilot cluster-RCT and assess the quality of the deliberative process qualitatively and quantitatively.

Take Home Message for practice: Interventions to optimize prescribing are often not implemented in routine care. Engaging stakeholders through deliberative consultations may support the development of evidence-based, feasible, and implementable components to reduce medication-related harm in GP.