Better drug use in advanced disease: An international Delphi study

Bregje A. A. Huisman, Eric C. T. Geijteman, Marianne K. Dees, Lia van Zuylen, Agnes van der Heide, Roberto S. G. M. Perez

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Patients with a limited life expectancy use many medications, some of which may be questionable. Objectives: To identify possible solutions for difficulties concerning medication management and formulate recommendations to improve medication management at the end of life. Methods: A two-round Delphi study with experts in the field of medication management and end-of-life care (based on ranking in the citation index in Web of Science and relevant publications). We developed a questionnaire with 58 possible solutions for problems regarding medication management at the end of life that were identified in previously performed studies. Results: A total of 42 experts from 13 countries participated. Response rate in the first round was 93%, mean agreement between experts for all solutions was 87 % (range 62%-100%); additional suggestions were given by 51%. The response rate in the second round was 74%. Awareness, education and timely communication about medication management came forward as top priorities for guidelines. In addition, solutions considered crucial by many of the experts were development of a list of inappropriate medications at the end of life and incorporation of recommendations for end-of-life medication management in disease-specific guidelines. Conclusions: In this international Delphi study, experts reached a high level of consensus on recommendations to improve medication management in end-of-life care. These findings may contribute to the development of clinical practice guidelines for medication management in end-of-life care.
Original languageEnglish
JournalBMJ Supportive & Palliative Care
Early online date2018
DOIs
Publication statusPublished - 2018

Cite this

Huisman, Bregje A. A. ; Geijteman, Eric C. T. ; Dees, Marianne K. ; van Zuylen, Lia ; van der Heide, Agnes ; Perez, Roberto S. G. M. / Better drug use in advanced disease: An international Delphi study. In: BMJ Supportive & Palliative Care. 2018.
@article{251f0cf2b24143dab2d29ae52bc81ca1,
title = "Better drug use in advanced disease: An international Delphi study",
abstract = "Patients with a limited life expectancy use many medications, some of which may be questionable. Objectives: To identify possible solutions for difficulties concerning medication management and formulate recommendations to improve medication management at the end of life. Methods: A two-round Delphi study with experts in the field of medication management and end-of-life care (based on ranking in the citation index in Web of Science and relevant publications). We developed a questionnaire with 58 possible solutions for problems regarding medication management at the end of life that were identified in previously performed studies. Results: A total of 42 experts from 13 countries participated. Response rate in the first round was 93{\%}, mean agreement between experts for all solutions was 87 {\%} (range 62{\%}-100{\%}); additional suggestions were given by 51{\%}. The response rate in the second round was 74{\%}. Awareness, education and timely communication about medication management came forward as top priorities for guidelines. In addition, solutions considered crucial by many of the experts were development of a list of inappropriate medications at the end of life and incorporation of recommendations for end-of-life medication management in disease-specific guidelines. Conclusions: In this international Delphi study, experts reached a high level of consensus on recommendations to improve medication management in end-of-life care. These findings may contribute to the development of clinical practice guidelines for medication management in end-of-life care.",
author = "Huisman, {Bregje A. A.} and Geijteman, {Eric C. T.} and Dees, {Marianne K.} and {van Zuylen}, Lia and {van der Heide}, Agnes and Perez, {Roberto S. G. M.}",
year = "2018",
doi = "10.1136/bmjspcare-2018-001623",
language = "English",
journal = "BMJ Supportive & Palliative Care",
issn = "2045-435X",
publisher = "BMJ Publishing Group",

}

Better drug use in advanced disease: An international Delphi study. / Huisman, Bregje A. A.; Geijteman, Eric C. T.; Dees, Marianne K.; van Zuylen, Lia; van der Heide, Agnes; Perez, Roberto S. G. M.

In: BMJ Supportive & Palliative Care, 2018.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Better drug use in advanced disease: An international Delphi study

AU - Huisman, Bregje A. A.

AU - Geijteman, Eric C. T.

AU - Dees, Marianne K.

AU - van Zuylen, Lia

AU - van der Heide, Agnes

AU - Perez, Roberto S. G. M.

PY - 2018

Y1 - 2018

N2 - Patients with a limited life expectancy use many medications, some of which may be questionable. Objectives: To identify possible solutions for difficulties concerning medication management and formulate recommendations to improve medication management at the end of life. Methods: A two-round Delphi study with experts in the field of medication management and end-of-life care (based on ranking in the citation index in Web of Science and relevant publications). We developed a questionnaire with 58 possible solutions for problems regarding medication management at the end of life that were identified in previously performed studies. Results: A total of 42 experts from 13 countries participated. Response rate in the first round was 93%, mean agreement between experts for all solutions was 87 % (range 62%-100%); additional suggestions were given by 51%. The response rate in the second round was 74%. Awareness, education and timely communication about medication management came forward as top priorities for guidelines. In addition, solutions considered crucial by many of the experts were development of a list of inappropriate medications at the end of life and incorporation of recommendations for end-of-life medication management in disease-specific guidelines. Conclusions: In this international Delphi study, experts reached a high level of consensus on recommendations to improve medication management in end-of-life care. These findings may contribute to the development of clinical practice guidelines for medication management in end-of-life care.

AB - Patients with a limited life expectancy use many medications, some of which may be questionable. Objectives: To identify possible solutions for difficulties concerning medication management and formulate recommendations to improve medication management at the end of life. Methods: A two-round Delphi study with experts in the field of medication management and end-of-life care (based on ranking in the citation index in Web of Science and relevant publications). We developed a questionnaire with 58 possible solutions for problems regarding medication management at the end of life that were identified in previously performed studies. Results: A total of 42 experts from 13 countries participated. Response rate in the first round was 93%, mean agreement between experts for all solutions was 87 % (range 62%-100%); additional suggestions were given by 51%. The response rate in the second round was 74%. Awareness, education and timely communication about medication management came forward as top priorities for guidelines. In addition, solutions considered crucial by many of the experts were development of a list of inappropriate medications at the end of life and incorporation of recommendations for end-of-life medication management in disease-specific guidelines. Conclusions: In this international Delphi study, experts reached a high level of consensus on recommendations to improve medication management in end-of-life care. These findings may contribute to the development of clinical practice guidelines for medication management in end-of-life care.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85056765648&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30446489

U2 - 10.1136/bmjspcare-2018-001623

DO - 10.1136/bmjspcare-2018-001623

M3 - Article

JO - BMJ Supportive & Palliative Care

JF - BMJ Supportive & Palliative Care

SN - 2045-435X

ER -