Hannah De Schutter1, Julie Hias2,3, Laura Hellemans2,3,4, Karolien Walgraeve2, Jos Tournoy5,6, Peter Verhamme7,8, Peter Sinnaeve7,8, Rik Willems7,8, Walter Droogné7,8, Christophe Vandenbriele7,8, Lucas Van Aelst7,8, Thomas Vanassche7,8, Lorenz Van der Linden2,3. 1. Pharmacy Department, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium. hannahdeschutter8@gmail.com. 2. Pharmacy Department, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium. 3. Department of Pharmaceutical and Pharmacological Sciences, University of Leuven, Louvain, Belgium. 4. Research Foundation Flanders, Brussels, Belgium. 5. Department of Public Health and Primary Care, University of Leuven, Louvain, Belgium. 6. Department of Geriatric Medicine, University Hospitals Leuven, Louvain, Belgium. 7. Department of Cardiovascular Diseases, University Hospitals Leuven, Louvain, Belgium. 8. Department of Cardiovascular Sciences, University of Leuven, Louvain, Belgium.
Abstract
PURPOSE: Cardiovascular agents commonly used in geriatric patients, are linked to potentially avoidable harm and might hence be a suitable substrate for medication review practices. Therefore, we sought to update and validate the content of the cardiovascular segment of the previously published Rationalization of Home Medication by an Adjusted STOPP list in Older Patients (RASP) List. METHODS: A three-step study was conducted by the pharmacy department in collaboration with the geriatric medicine and cardiology department at the University Hospitals Leuven, Belgium. First, the cardiovascular segment of the RASP list version 2014 was updated taking into account published research, other screening tools and the input of end-users. Secondly, this draft was reviewed during three panel discussions with five expert cardiologists and three clinical pharmacists, all of whom had relevant expertise in geriatric pharmacotherapy. Thirdly, the content was validated using a modified Delphi Technique by a panel of European hospital pharmacists, cardiologists, geriatricians and an internal medicine physician. RESULTS: After the first and second step, the RASP_CARDIO list comprised 94 statements. Consensus (≥ 80% agreement) of all statements and one new statement about gliflozins in heart failure was achieved by a panel of seventeen experts across four European countries after two validation rounds. The final construct comprised a list of 95 statements related to potentially inappropriate prescribing of cardiovascular agents. CONCLUSION: The RASP_CARDIO list is an updated and validated explicit screening tool to optimize cardiovascular pharmacotherapy in geriatric patients.
PURPOSE: Cardiovascular agents commonly used in geriatric patients, are linked to potentially avoidable harm and might hence be a suitable substrate for medication review practices. Therefore, we sought to update and validate the content of the cardiovascular segment of the previously published Rationalization of Home Medication by an Adjusted STOPP list in Older Patients (RASP) List. METHODS: A three-step study was conducted by the pharmacy department in collaboration with the geriatric medicine and cardiology department at the University Hospitals Leuven, Belgium. First, the cardiovascular segment of the RASP list version 2014 was updated taking into account published research, other screening tools and the input of end-users. Secondly, this draft was reviewed during three panel discussions with five expert cardiologists and three clinical pharmacists, all of whom had relevant expertise in geriatric pharmacotherapy. Thirdly, the content was validated using a modified Delphi Technique by a panel of European hospital pharmacists, cardiologists, geriatricians and an internal medicine physician. RESULTS: After the first and second step, the RASP_CARDIO list comprised 94 statements. Consensus (≥ 80% agreement) of all statements and one new statement about gliflozins in heart failure was achieved by a panel of seventeen experts across four European countries after two validation rounds. The final construct comprised a list of 95 statements related to potentially inappropriate prescribing of cardiovascular agents. CONCLUSION: The RASP_CARDIO list is an updated and validated explicit screening tool to optimize cardiovascular pharmacotherapy in geriatric patients.
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