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. 2023 Oct;13(e1):e115-e121.
doi: 10.1136/bmjspcare-2018-001623. Epub 2018 Nov 15.

Better drug use in advanced disease: an international Delphi study

Bregje A A Huisman  1 , Eric C T Geijteman  2   3 , Marianne K Dees  4 , Lia van Zuylen  2 , Agnes van der Heide  3 , Roberto S G M Perez  5
Affiliations

Better drug use in advanced disease: an international Delphi study

Bregje A A Huisman et al. BMJ Support Palliat Care. 2023 Oct.

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.

Keywords: delphi technique; drug utilization review; end-of-life care; medication therapy management; palliative care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of the Delphi procedure.
See this image and copyright information in PMC

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