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. 2024 Jul 18:15:100479.
doi: 10.1016/j.rcsop.2024.100479. eCollection 2024 Sep.

Stakeholders' perspectives about challenges, strategies and outcomes of importance associated with adherence to appropriate polypharmacy in older patients - A qualitative study

Hanadi A Al Shaker  1   2 , Heather E Barry  1 , Carmel M Hughes  1
Affiliations

Stakeholders' perspectives about challenges, strategies and outcomes of importance associated with adherence to appropriate polypharmacy in older patients - A qualitative study

Hanadi A Al Shaker et al. Explor Res Clin Soc Pharm. .

Abstract

Background: Older patients experience challenges when taking polypharmacy. Studies have applied different interventions to improve adherence to polypharmacy. However, inconsistencies in outcomes have impeded the synthesis of evidence. To generate high-quality studies and selectively report outcomes, a Core Outcome Set (COS) is advocated.

Objectives: This study explored stakeholders' perspectives about the challenges older patients face when taking polypharmacy, strategies to overcome each challenge, and outcomes of importance that may contribute to COS development.

Methods: Semi-structured interviews were undertaken with academics, healthcare professionals, and public participants. A series of open-ended questions investigated challenges with adherence to polypharmacy in older patients and strategies to overcome these challenges. A list of outcomes (n = 7) compiled from previous studies associated with adherence to polypharmacy was presented to participants for their views. Content analysis was conducted to identify key themes and outcomes proposed by participants.

Results: Participants suggested 11 multidimensional healthcare system-related, medication-related, patient-related, and socioeconomic-related challenges and 16 educational and behavioural strategies associated with adherence to polypharmacy in older patients. Participants agreed with the importance of the seven outcomes presented and suggested a further six outcomes they deemed to be important for use in trials aimed at improving adherence to appropriate polypharmacy in older patients.

Conclusions: Adherence to polypharmacy was deemed challenging, requiring supportive interventions. A list of 13 outcomes in the context of adherence to appropriate polypharmacy in older patients was identified to inform a future study that will develop a COS for clinical trials targeting interventions to improve adherence to appropriate polypharmacy in older patients.

Keywords: Adherence; Interview; Older people; Outcomes; Polypharmacy; Qualitative research.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The core outcome set (COS) development process. Adapted from: Williamson et al. (2017, p. 6). COMET: Core Outcome Measures in Effectiveness Trials, COS: Core Outcome Set, COS-STAR: Core Outcome Set–STAndards for Reporting.
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