International core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy.

Beuscart, Jean-Baptiste; Knol, Wilma; Cullinan, Shane; Schneider, Claudio; Dalleur, Olivia; Boland, Benoit; Thevelin, Stefanie; Jansen, Paul A F; O'Mahony, Denis; Rodondi, Nicolas; Spinewine, Anne (2018). International core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy. BMC medicine, 16(1), p. 21. BioMed Central 10.1186/s12916-018-1007-9

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BACKGROUND Comparisons of clinical trial findings in systematic reviews can be hindered by the heterogeneity of the outcomes reported. Moreover, the outcomes that matter most to patients might be underreported. A core outcome set can address these issues, as it defines a minimum set of outcomes that should be reported in all clinical trials in a particular area of research. The objective in this study was to develop a core outcome set for clinical trials of medication review in multi-morbid older patients with polypharmacy. METHODS Firstly, eligible outcomes were identified through a systematic review of trials of medication review in older patients (≥65 years) and interviews with 15 older patients. Secondly, an international three-round Delphi survey in four countries involving patients, healthcare professionals, and experts was conducted to validate outcomes to be included in the core outcome set. Consensus meetings were conducted to validate the results. RESULTS Of the 164 participants invited to take part in the Delphi survey, 150 completed Round 1, including 55 patients or family caregivers, 55 healthcare professionals, and 40 experts. A total of 129 participants completed all three rounds. Sixty-four eligible outcomes were extracted from 47 articles, 32 clinical trial protocols, and patient interviews. Thirty outcomes were removed and one added after Round 1, 18 outcomes were removed after Round 2, and seven after Round 3. Results were discussed during consensus meetings. Consensus was reached on seven outcomes, which constitute the core outcome set: drug-related hospital admissions; drug overuse; drug underuse; potentially inappropriate medications; clinically significant drug-drug interactions; health-related quality of life; pain relief. CONCLUSIONS We developed a core outcome set of seven outcomes which should be used in future trials of medication review in multi-morbid older patients with polypharmacy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Schneider, Claudio and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1741-7015

Publisher:

BioMed Central

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

14 Feb 2018 08:45

Last Modified:

26 Oct 2019 07:59

Publisher DOI:

10.1186/s12916-018-1007-9

PubMed ID:

29433501

Uncontrolled Keywords:

Consensus Core outcome set Delphi survey Medication review Multi-morbidity Older patients Polypharmacy

BORIS DOI:

10.7892/boris.111664

URI:

https://boris.unibe.ch/id/eprint/111664

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