This is a prospective, multi-phase interventional study evaluating the clinical utility and efficacy of POLYMED-a bilingual (Arabic/English) web-based, explainable-AI medication risk calculator-on optimizing geriatric medication safety in Muscat primary care. The primary objective is to evaluate whether deploying this clinical decision support software at the point of care systematically reduces potentially inappropriate prescribing (PIP) and polypharmacy among elderly patients.
The study protocol integrates baseline parameterization with an active clinical intervention:
* Phase 1 \& 2 (Baseline \& Tool Validation): A baseline cross-sectional assessment of elderly patients is conducted to quantify local prescribing burdens via international criteria (2023 AGS Beers / STOPP/START v3). These prospective baseline data are used to calibrate and validate the OPIP Score engine powering the POLYMED calculator. * Phase 3 (Active Intervention Phase): A prospective before-and-after trial evaluates the direct clinical effect of the tool. Clinicians are assigned by the study protocol to actively deploy the POLYMED calculator at the point of care during consultations. The trial measures the resulting changes in polypharmacy burden and medication spending compared to standard, routine care.
• Aged 65 years or older at the time of recruitment
Registered in a chronic disease clinic in a participating primary healthcare centre
Receiving at least one long-term prescribed medication for chronic disease management
Able to provide informed consent independently
• Cognitive impairment or severe communication limitations precluding informed consent
Currently receiving palliative care
Currently admitted as an inpatient during the recruitment period
Major medication regimen change within the preceding four weeks
Single group
OPIP Score Calculator (Oman Potentially Inappropriate Prescribing Risk Score)
DeviceA bilingual (Arabic/English) web-based clinical decision support tool designed to systematically intercept prescribing risks. The software features a three-layer architecture: a rule-based engine executing the 2023 AGS Beers Criteria (incorporating drug-drug interactions and renal dosing alerts), a risk-scoring model calibrated to local Omani clinical data, and an explainable-AI narrative providing explicit, prioritized recommendations. Per the interventional study protocol, clinicians are mandated to deploy this tool at the point of care during consultations to trigger real-time medication reviews. While clinicians maintain final medical autonomy over prescribing modifications, the systematic application of the tool and the mandatory documentation of clinical overrides are driven prospectively by the investigator's study design to alter and optimize the standard care pathway.
• Reduction in the prevalence of potentially inappropriate medication prescribing following OPIP Score integration, reassessed using the 2023 AGS Beers Criteria
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