Identification of intervention strategies to reduce preventable drug-related morbidity in older adults

Background: Drug-related morbidity (DRM) results in significant costs and consequences. Although 50% or more of DRM may be preventable (PDRM), strategies to reduce the problem of PDRM have not yet been identified. The purpose of this study was to determine the perceived efficacy of each of 8 strategies for reducing PDRM, as expressed by physicians. Methods: Three panels of physicians (12 general practitioners [GPs], 6 geriatricians and 6 clinical pharmacologists) who had previously developed and validated clinical indicators of PDRM in older adults, received a follow-up mail survey to identify strategies to reduce PDRM. Each physician was asked to decide how best to reduce PDRM, by choosing from 8 strategies for each clinical indicator as many preventive intervention methods as they felt could be useful. Results: Overall, monitoring was the most frequently chosen strategy per indicator. The GPs and clinical pharmacologists chose monitoring most frequently per indicator, while the geriatricians chose health-system management most frequently per indicator. For each PDRM indicator, an average of 3.95 intervention strategies were chosen. Conclusion: Monitoring and health-system management were strategies identified most frequently by physicians to reduce PDRM. Future research should focus on evaluating patient health outcomes associated with strategy implementation.