J.Y.TANG1, P.S.Y.LUN1, J.P.H.TENG1, W.S.T.ANG2, K.T.TAN3, Y.Y.DING1
Geriatric Education and Research Institute1, Changi General Hospital2, Tan Tock Seng Hospital3
Potentially inappropriate prescribing is a rising concern among older adults due to multimorbidity and polypharmacy. Various interventions to facilitate appropriate prescribing have been conducted around the world. The aims of this study are to identify (1) potential intervention elements, and (2) potential strategies in the form of behavior change techniques that geriatricians in Singapore considered as important factors that would help to optimize prescribing.
A two-round modified Delphi study was conducted with 20 geriatricians from seven public hospitals in Singapore. Sixty-nine statements were formulated from a scoping review and presented in Round 1 survey, while round 2 contained 23 statements, with some refinement based on round 1 comments. All statements were rated using a 7 point-Likert scale on their importance and impact.
Ninety percent of the statements presented achieved consensus. Seven intervention elements were picked as important: Medication Review, Training, Medication Therapy Management, Shared Decision Making, Patient Interview, Medication Reconciliation, and Comprehensive Geriatric Assessment. Some commonly identified behavior change techniques included goal setting (behavior), goal setting (outcome) and problem solving.
Our Delphi panels’ pick mirrored results from the scoping review. Most of the statements involving the roles of pharmacists were highly regarded, which corroborated with findings in the literature that pharmacists play important collaborative roles in reducing potentially inappropriate prescribing among older adults with multimorbidity. Identification of potential intervention elements and their potential strategies would aid in the development of a context-relevant intervention to optimize prescribing in this population.