Jia Ying Tang1, Penny Lun2, Poh Hoon June Teng2, Wendy Ang3, Keng Teng Tan4, Yew Yoong Ding2,5. 1. Geriatric Education and Research Institute Limited, 2 Yishun Central 2, Singapore, 768024, Singapore. tang.jia.ying@geri.com.sg. 2. Geriatric Education and Research Institute Limited, 2 Yishun Central 2, Singapore, 768024, Singapore. 3. Department of Pharmacy, Changi General Hospital, Singapore, Singapore. 4. Department of Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore. 5. Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
Abstract
PURPOSE: Potentially inappropriate prescribing among older adults is a rising concern, attributed mainly by polypharmacy and multimorbidity. We aimed to identify key components and strategies for construction of a context-relevant intervention to facilitate appropriate prescribing in outpatient clinics in Singapore. METHODS: The modified Delphi study was conducted in two rounds with 20 geriatricians from seven public hospitals in Singapore. Round one survey presented 69 statements formulated from a scoping review, while round two presented 23 statements with some modifications based on round one comments. The statements were rated against a 7-point Likert scale on their importance and impact on prescribing for older adults with multimorbidty. RESULTS: Consensus were achieved for 90% of the statements. Seven intervention elements were identified as being important: medication review, training, medication therapy management, shared decision making, patient interview, medication reconciliation, comprehensive geriatric assessment. In addition, some commonly identified behavior change techniques included goal setting (behavior), goal setting (outcome) and problem solving. CONCLUSIONS: This study identified important intervention elements and their potential strategies that could be adopted in an intervention to optimize appropriate prescribing for older adults with multimorbidity.
PURPOSE: Potentially inappropriate prescribing among older adults is a rising concern, attributed mainly by polypharmacy and multimorbidity. We aimed to identify key components and strategies for construction of a context-relevant intervention to facilitate appropriate prescribing in outpatient clinics in Singapore. METHODS: The modified Delphi study was conducted in two rounds with 20 geriatricians from seven public hospitals in Singapore. Round one survey presented 69 statements formulated from a scoping review, while round two presented 23 statements with some modifications based on round one comments. The statements were rated against a 7-point Likert scale on their importance and impact on prescribing for older adults with multimorbidty. RESULTS: Consensus were achieved for 90% of the statements. Seven intervention elements were identified as being important: medication review, training, medication therapy management, shared decision making, patient interview, medication reconciliation, comprehensive geriatric assessment. In addition, some commonly identified behavior change techniques included goal setting (behavior), goal setting (outcome) and problem solving. CONCLUSIONS: This study identified important intervention elements and their potential strategies that could be adopted in an intervention to optimize appropriate prescribing for older adults with multimorbidity.
Authors: J T Hanlon; K E Schmader; G P Samsa; M Weinberger; K M Uttech; I K Lewis; H J Cohen; J R Feussner Journal: J Clin Epidemiol Date: 1992-10 Impact factor: 6.437
Authors: Denis O'Mahony; David O'Sullivan; Stephen Byrne; Marie Noelle O'Connor; Cristin Ryan; Paul Gallagher Journal: Age Ageing Date: 2014-10-16 Impact factor: 10.668