Development of a list of consensus-approved clinical indicators of preventable drug-related morbidity in older adults

Heather A. Robertson, Neil J. MacKinnon

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Background: Older patients (aged >65 years) may experience drug-related problems that, if unrecognized, can result in drug-related morbidities (DRMs). According to the literature, 49% to 76% of all DRMs may be preventable; however, there is little consensus as to which are preventable and which are not. Objective: The aim of this study was to develop consensus-approved clinical indicators of preventable DRM (PDRM) in older adults. Geriatricians, clinical pharmacologists, general practitioners, and clinical pharmacists were included in the consensus-building process. Methods: In 2001, a survey containing potential indicators of PDRM was prepared based on previous research and the input of 2 clinical pharmacists. The survey was administered concurrently via the Delphi technique to 2 separate specialist panels (6 geriatricians and 6 clinical pharmacologists) to generate clinical indicators of PDRMs in older adults. Subsequently, a focus group of 12 general practitioners (GPs) assessed these PDRM indicators in Nova Scotia, Canada. Results: The specialist panels generated 58 consensus-approved clinical indicators of PDRMs in older adults after 2 rounds of the Delphi technique. The GPs agreed with 52 (90%) of these PDRM indicators. Conclusions: This study generated consensus-approved indicators of PDRMs in older adults, which could be used by health professionals to identify patients at risk for PDRMs. The indicators could also have a role in quality measurement systems and in epidemiologic research. Furthermore, the indicators could complement existing clinical indicators and establish an important link between patterns of care and clinical outcomes.

Original languageEnglish (US)
Pages (from-to)1595-1613
Number of pages19
JournalClinical Therapeutics
Volume24
Issue number10
DOIs
StatePublished - Oct 1 2002
Externally publishedYes

Keywords

  • Adverse events
  • Medication use
  • Older adults
  • Polypharmacy
  • Preventable drug-related morbidity

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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