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The CMA concerns a clinical rule based and pharmacist-led medication review service. The aim of this study was to explore both physicians\u2019 and pharmacists\u2019 feedback on the optimised CMA service to further improve the service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An anonymous e-questionnaire was sent to all physicians active in the University Hospitals Leuven (n\u2009=\u20091631) and to all clinical pharmacists performing the CMA service (n\u2009=\u200916). Feedback was collected using multiple choice questions. During a 5-month period, physicians were also contacted in case of non-acceptance of recommendations to investigate barriers affecting implementation. Thematic analysis was performed and additional acceptance after telephone contact within 24\u00a0h was registered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 119 physicians (7.3%) and 16 pharmacists (100%) completed the e-questionnaire. The overall service was assessed as clinically relevant to highly relevant by 77.7% of physicians. The main reasons for non-acceptance of recommendations were related to workload, work environment and time constraints. About two thirds (66.3%) of initially not-accepted recommendations were accepted after phone contact. A nearly full consensus was reached among pharmacists (15\/16) on the centralised CMA being complementary to current clinical pharmacy activities. Two major barriers were reported by pharmacists: (1) too limited time allocation and (2) a large number of irrelevant alerts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The CMA was perceived as clinically relevant by the majority of end-users. Acceptance rate of pharmaceutical recommendations was further increased by calling the physician. Increasing the specificity of clinical rules in the future is imperative.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12911-022-01921-7","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T15:44:26Z","timestamp":1657035866000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["End-users feedback and perceptions associated with the implementation of a clinical-rule based Check of Medication Appropriateness service"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6072-2596","authenticated-orcid":false,"given":"Charlotte","family":"Quintens","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willy E.","family":"Peetermans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenz","family":"Van der Linden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Declercq","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"Van den Bosch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Spriet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"issue":"November","key":"1921_CR1","first-page":"1","volume":"363","author":"AJ Avery","year":"2018","unstructured":"Avery AJ, Coleman JJ. 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Participation was voluntary. Analysed data were entirely anonymised and included no information that could be used to identify specific participants, and they were guaranteed to no unethical use of the information. Therefore, no consent to participate was required for this study according to the institutional and\/or national research committee \u2018Ethics Committee Research University Hospitals Leuven, Belgium\u2019. All methods were performed in accordance with the relevant guidelines and the institutional regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"IS and LVDL are supported by the Clinical Research Fund of the University Hospitals Leuven. The other authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"177"}}