Core Outcome Set for Trials Aimed at Improving the Appropriateness of Polypharmacy in Older People in Primary Care.

Autor: Rankin A; School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom., Cadogan CA; School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland., In Ryan C; School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland., Clyne B; Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland., Smith SM; Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland., Hughes CM; School of Pharmacy, Queen's University Belfast, Belfast, United Kingdom.
Jazyk: angličtina
Zdroj: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2018 Jul; Vol. 66 (6), pp. 1206-1212. Date of Electronic Publication: 2018 Feb 20.
DOI: 10.1111/jgs.15245
Abstrakt: Objectives: To develop a core outcome set (COS) for use in effectiveness trials of interventions aiming to improve the appropriateness of polypharmacy in older people in primary care.
Design: Standard COS development methodology was followed, comprising identification of outcomes of studies from an update of a Cochrane systematic review and previously collected qualitative data and an online Delphi consensus exercise involving three rounds.
Participants: An international panel of 160 stakeholders comprising 120 healthcare experts and a public participant panel of 40 older people.
Measurements: Outcomes identified from studies included in the Cochrane review and secondary analysis of previously collected qualitative data were scored on a 9-point Likert scale using the GRADE scoring system anchored at 1 (not important) and 9 (critical). Consensus criteria for the COS were defined as 70% or more of participants scoring the outcome as critical and 15% or fewer scoring the outcome as not important.
Results: Twenty-nine outcomes identified from the Cochrane review and existing qualitative data were included in the Delphi exercise. The final COS comprised 16 outcomes. The 7 highest-ranked outcomes were serious adverse drug reactions, medication appropriateness, falls, medication regimen complexity, quality of life, mortality, and medication side effects.
Conclusion: A COS for interventions aiming to improve the appropriateness of polypharmacy for older people in primary care has been developed. Future work will focus on identifying appropriate tools to measure.
(© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.)
Databáze: MEDLINE
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