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  • Stewart, DerekRobert Gordon Univ, Sch Pharm & Life Sci, Aberdeen, Scotland. (author)

A modified Delphi study to determine the level of consensus across the European Union on the structures, processes and desired outcomes of the management of polypharmacy in older people

  • Article/chapterEnglish2017

Publisher, publication year, extent ...

  • 2017-11-20
  • Public Library of Science (PLoS),2017
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-343320
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-343320URI
  • https://doi.org/10.1371/journal.pone.0188348DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background Inappropriate use of multiple medicines (inappropriate polypharmacy) is a major challenge in older people with consequences of increased prevalence and severity of adverse drug reactions and interactions, and reduced medicines adherence. The aim of this study was to determine the levels of consensus amongst key stakeholders in the European Union (EU) in relation to aspects of the management of polypharmacy in older people. Methods Forty-six statements were developed on aspects of healthcare structures, processes and desired outcomes, with consensus defined at >= 80% agreement. Panel members were strategists (e.g. directors, leading clinicians and commissioners) from each of the 28 EU member states, with a target recruitment of five per member state. Three Delphi rounds were conducted via email, with panel members being provided with summative results and collated, anonymised comments at the commencement of Rounds 2 and 3. Results Ninety panel members were recruited (64.3% of target), with high participation levels throughout the three Delphi rounds (91.1%, 83.3%, 72.2%). During Round 1, consensus was obtained for 27/46 statements (58.7%), with an additional two statements in Round 2 and none in Round 3. Consensus was obtained for statements relating to: potential gain arising from polypharmacy management (3/4 statements); strategic development (7/7); change management (5/7) indicator measures (4/6); legislation (0/3); awareness raising (5/5); polypharmacy reviews (5/7); and EU vision (0/7). Analysis of free text comments indicated that the vision statements were too ambitious and not achievable by the specified timeframe of 2025. Conclusion Consensus was obtained amongst key EU strategists around many aspects of polypharmacy management in older people. Notably, no consensus was achieved in relation to statements relating to the need to alter legislation in areas of healthcare delivery, remuneration and practitioner scope of practice. While the vision for the EU by 2025 was considered rather ambitious, there is great potential and clear opportunity to advance polypharmacy management throughout the EU and beyond.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Gibson-Smith, KathrineRobert Gordon Univ, Sch Pharm & Life Sci, Aberdeen, Scotland. (author)
  • MacLure, KatieRobert Gordon Univ, Sch Pharm & Life Sci, Aberdeen, Scotland. (author)
  • Mair, AlpanaScottish Govt, Effect Prescribing & Therapeut Hlth & Social Care, Edinburgh, Midlothian, Scotland. (author)
  • Alonso, AlbertFCRB, Directorate Res & Innovat, Barcelona, Spain. (author)
  • Codina, CarlesHosp Clin Barcelona, Pharm Dept, Barcelona, Spain. (author)
  • Cittadini, AntonioUniv Federico II, Dept Translat Med Sci, Naples, Italy. (author)
  • Fernandez-Llimos, FernandoUniv Lisbon, Fac Pharm, Dept Social Pharm, Inst Med Res iMed Ulisboa, Lisbon, Portugal. (author)
  • Fleming, GlendaNorthern Hlth & Social Care Trust, Med Optimisat Innovat Ctr, Belfast, Antrim, North Ireland. (author)
  • Gennimata, DimitraUniv Peloponnese, Dept Social & Educ Policy, Corinthos, Greece. (author)
  • Gillespie, UlrikaUppsala universitet,Institutionen för farmaceutisk biovetenskap(Swepub:uu)uleng956 (author)
  • Harrison, CathyDept Hlth Social Serv & Publ Safety, Belfast, Antrim, North Ireland. (author)
  • Junius-Walker, UlrikeHannover Med Sch, Inst Gen Med, Hannover, Germany. (author)
  • Kardas, PrzemyslawMed Univ Lodz, Dept Family Med, Lodz, Poland. (author)
  • Kempen, ThomasUppsala universitet,Klinisk farmakogenomik och osteoporos(Swepub:uu)thoke244 (author)
  • Kinnear, MoiraWestern Gen Hosp, NHS Lothian Pharm Serv, Edinburgh, Midlothian, Scotland. (author)
  • Lewek, PawelMed Univ Lodz, Dept Family Med, Lodz, Poland. (author)
  • Malva, JoaoUniv Coimbra, Fac Med, Coimbra, Portugal. (author)
  • McIntosh, JenniferFCRB, Directorate Res & Innovat, Barcelona, Spain. (author)
  • Scullin, ClaireQueens Univ, Sch Pharm, Belfast, Antrim, North Ireland. (author)
  • Wiese, BirgittHannover Med Sch, Inst Gen Med, Hannover, Germany. (author)
  • Robert Gordon Univ, Sch Pharm & Life Sci, Aberdeen, Scotland.Scottish Govt, Effect Prescribing & Therapeut Hlth & Social Care, Edinburgh, Midlothian, Scotland. (creator_code:org_t)

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  • In:PLOS ONE: Public Library of Science (PLoS)12:111932-6203

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