COMET Initiative | Stakeholders' perspectives about challenges, strategies and outcomes of importance associated with adherence to appropriate polypharmacy in older patients

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

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.

Objective(s)
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.

Contributors

Hanadi A. Al Shaker, Heather E. Barry, Carmel M. Hughes

Publication

Journal: Exploratory Research in Clinical and Social Pharmacy
Volume: 15
Issue:
Pages: -
Year: 2024
DOI: 10.1016/j.rcsop.2024.100479

Further Study Information

Current Stage: Completed
Date:
Funding source(s):

Health Area

Disease Category: Health care of older people

Disease Name: Medication adherence

Target Population

Age Range: 65 - 110

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Academic research representatives
- Clinical experts
- Patient/ support group representatives
- Researchers

Study Type

- Patient perspectives

Method(s)

- Interview

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.