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De-prescribing medication may cause concern for patients and GPs. To date, there is limited research explicitly focussing on attitudes to reduce treatment in older people. The OPTiMISE trial will conduct qualitative sub-studies during the first two feasibility phases to help understand these concerns and to enable the development of the study approach and materials, to ensure high recruitment rates in the main trial.

Qualitative Sub-Studies

Led by Dr Jenni Burt, Department of Public Health and Primary Care School of Clinical Medicine, University of Cambridge.

Qualitative Sub-study 1


To determine the barriers and facilitators for patients and GPs to reducing antihypertensive medication and inform development of trial recruitment procedures and materials.


Face-to-face interviews with 15 GPs and 15 patients will be conducted and analysed .

Qualitative Sub-study 2


To inform understanding of the presentation of information within recruitment appointments, and how this might impact on consent to participate, with a view to ensuring robust procedures.


Recruitment appointments of 75 patients potentially eligible for the trial will be audio-recorded and analysed.

Economic Sub-study

Led by Dr Sue Jowett, Institute of Applied Health Research, University of Birmingham.


To determine the cost-effectiveness of the intervention in terms of cardiovascular, quality of life and cost outcomes.


The Markov cost-effectiveness models estimate the long-term costs and benefits from blood pressure lowering in younger populations. This model will be adapted to include harms of treatment with adjustment of the effects of blood pressure lowering on cardiovascular disease risk, costs and quality-adjusted-life years (QALYs) to match the older population involved in this work.

Costs of the therapies prescribed, side effects and acute and long term costs of cardiovascular events will be obtained within the trial and from the literature.